Increased oxygenation is associated with myocardial inflammation and adverse regional remodeling after acute ST-segment elevation myocardial infarction

Shi, Ke; Ma, Min; Yang, Meng‐Xi; Xia, Chunchao; Peng, Wanlin; He, Yong; Li, Zhenlin; Guo, Yingkun; Yang, Zhi‐gang

doi:10.1007/s00330-021-08032-3

Cited by 3 publications

(1 citation statement)

References 35 publications

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“…The MVO is a severe marker of microvascular blood flow dysfunction. The development of MVO depends on several factors: (1) the shedding of atherosclerotic or thrombotic debris caused by PCI [ 20 ], (2) vasospasm caused by the release of vasoconstrictor factors such as endothelin and thromboxane [ 21 ], (3) activation of platelets and coagulation factors in microvascular caused by endothelial cell injury [ 4 ], and (4) progressive inflammatory cells accumulation in the infarct area [ 22 ]. Our study showed that patients with MVO had significantly higher coronary scores than those without MVO.…”

Section: Discussionmentioning

confidence: 99%

Prediction of microvascular obstruction by coronary artery angiography score after acute ST-segment elevation myocardial infarction: a single-center retrospective observational study

Yin

Wang

et al. 2022

BMC Cardiovasc Disord

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Background Some coronary artery angiography (CAG) scores are associated with the no-reflow phenomenon after percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). However, quality evidence regarding the association between the CAG scores and microvascular injury is still needed. Our study aimed to validate the ability of the CAG scores in predicting microvascular obstruction (MVO) detected by cardiac magnetic resonance (CMR) imaging. Methods From October 2020 to October 2021, 141 consecutive patients with acute STEMI who underwent primary PCI and CMR were retrospectively reviewed. CMR imaging was performed between 3 and 7 days after PCI. The patients were divided into MVO and non-MVO group based on the CMR results. Three CAG scores (SYNTAX score, SYNTAX II score and Gensini score) were used to assess the severity of coronary artery atherosclerotic burden. Results A total of 122 patients were included (mean age 60.6 ± 12.8 years). MVO occurred in 51 patients (41.8%). Patients with MVO had higher SYNTAX scores, SYNTAX II scores and Gensini scores than those without MVO (all p < 0.001). The Gensini score (r = 0.567, p < 0.001) showed the strongest correlation with infarction size than SYNTAX score (r = 0.521, p < 0.001) and SYNTAX II score (r = 0.509, p < 0.001). The areas under the receiver operator characteristic curves of SYNTAX score, SYNTAX II score and Gensini score for predicting MVO patients were 0.726, 0.774 and 0.807. In multivariable regression analysis, peak troponin I (odd ratio [OR] = 1.236, p = 0.001) and SYNTAX II score (OR = 11.636, p = 0.010) were identified as independent predictors of MVO. Conclusions In patients with acute STEMI undergoing primary PCI treatment, the peak troponin I and SYNTAX II score may be an independent predictor of MVO.

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Section: Discussionmentioning

confidence: 99%

Prediction of microvascular obstruction by coronary artery angiography score after acute ST-segment elevation myocardial infarction: a single-center retrospective observational study

Yin

Wang

et al. 2022

BMC Cardiovasc Disord

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Association Between Myocardial Oxygenation and Fibrosis in Duchenne Muscular Dystrophy: Analysis by Rest Oxygenation‐Sensitive Magnetic Resonance Imaging

Zhou,

Xu,

Cai

et al. 2024

Magnetic Resonance Imaging

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BackgroundMyocardial hypoxia has been demonstrated in many cardiomyopathies and is related to development of myocardial fibrosis. However, myocardial hypoxia and its association with myocardial fibrosis are understudied in Duchenne muscular dystrophy (DMD)‐associated cardiomyopathy.PurposeTo evaluate myocardial hypoxia by oxygenation‐sensitive (OS) cardiac magnetic resonance imaging, and further explore its association with fibrosis.Study TypeProspective.SubjectsNinety‐one DMD boys (8.78 ± 2.32) and 30 healthy boys (9.07 ± 2.30).Field Strength/Sequence3 T, Balanced steady‐state free procession, Modified Look‐Locker inversion recovery sequence and Single‐shot phase‐sensitive inversion recovery sequence.AssessmentCardiac MRI data, including left ventricular functional, segmental native T1, and oxygenation signal‐intensity (SI) according to AHA 17‐segment model, were acquired. Patients were divided into LGE+ and LGE− groups. In patients with LGE, all segments were further classified as positive or negative segments by segmentally presence/absence of LGE.Statistical TestsVariables were compared using Student's t, Wilcoxon, Kruskal–Wallis test and one‐way analysis of variance. Bivariate Pearson or Spearman correlation were calculated to determine association between oxygenation SI and native T1. Variables with P < 0.10 in the univariable analysis were included in multivariable model. Receiver operating characteristic analysis was used to assess the performance of OS in diagnosing myocardial hypoxia.ResultsThe myocardial oxygenation SI of DMD was significantly decreased in all segments compared with normal controls, and more obvious in the LGE+ segments (0.46 ± 0.03 vs. 0.52 ± 0.03). For patients with and without LGE, myocardial oxygenation SI were significantly negatively correlated with native T1 in all segments (r = −0.23 to −0.42). The inferolateral oxygenation SI was a significant independent associator of LGE presence (adjusted OR = 0.900).Data ConclusionMyocardial hypoxia evaluated by the OS‐Cardiac‐MRI indeed occurs in DMD and associate with myocardial fibrosis, which might be used as a biomarker in assessing myocardial damage in DMD.Evidence Level1Technical EfficacyStage 1

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Left ventricular remodelling post-myocardial infarction: pathophysiology, imaging, and novel therapies

Frantz

Hundertmark

Schulz‐Menger

et al. 2022

European Heart Journal

204

110

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Most patients survive acute myocardial infarction (MI). Yet this encouraging development has certain drawbacks: heart failure (HF) prevalence is increasing and patients affected tend to have more comorbidities worsening economic strain on healthcare systems and impeding effective medical management. The heart’s pathological changes in structure and/or function, termed myocardial remodelling, significantly impact on patient outcomes. Risk factors like diabetes, chronic obstructive pulmonary disease, female sex, and others distinctly shape disease progression on the ‘road to HF’. Despite the availability of HF drugs that interact with general pathways involved in myocardial remodelling, targeted drugs remain absent, and patient risk stratification is poor. Hence, in this review, we highlight the pathophysiological basis, current diagnostic methods and available treatments for cardiac remodelling following MI. We further aim to provide a roadmap for developing improved risk stratification and novel medical and interventional therapies.

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Increased oxygenation is associated with myocardial inflammation and adverse regional remodeling after acute ST-segment elevation myocardial infarction

Cited by 3 publications

References 35 publications

Prediction of microvascular obstruction by coronary artery angiography score after acute ST-segment elevation myocardial infarction: a single-center retrospective observational study

Prediction of microvascular obstruction by coronary artery angiography score after acute ST-segment elevation myocardial infarction: a single-center retrospective observational study

Association Between Myocardial Oxygenation and Fibrosis in Duchenne Muscular Dystrophy: Analysis by Rest Oxygenation‐Sensitive Magnetic Resonance Imaging

Left ventricular remodelling post-myocardial infarction: pathophysiology, imaging, and novel therapies

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