Intracoronary ECG ST‐segment recovery during primary percutaneous intervention for ST‐segment myocardial infarction: Insights from a cardiac MRI study

Wong, D.; Leung, M.; Das, Rajiv; Puri, Rishi; Liew, G.; Teo, K.; Chew, Derek P.; Meredith, Ian T.; Worthley, M.; Worthley, Stephen G.

doi:10.1002/ccd.23455

Cited by 5 publications

(5 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…CMR has been compared with acute electrocardiographic ST segment resolution [49,105-108], angiographic measures [49,107,109-111], myocardial contrast echo [12,38] and recently, multidetector cardiac CT [112-114]. The methods generally correlate fairly well with one another in terms of diagnostic utility for MO.…”

Section: Ongoing Controversies and Future Directionsmentioning

confidence: 99%

CMR of microvascular obstruction and hemorrhage in myocardial infarction

2012

Journal of Cardiovascular Magnetic Resonance

143

144

View full text Add to dashboard Cite

Microvascular obstruction (MO) or no-reflow phenomenon is an established complication of coronary reperfusion therapy for acute myocardial infarction. It is increasingly recognized as a poor prognostic indicator and marker of subsequent adverse LV remodeling. Although MO can be assessed using various imaging modalities including electrocardiography, myocardial contrast echocardiography, nuclear scintigraphy, and coronary angiography, evaluation by cardiovascular magnetic resonance (CMR) is particularly useful in enhancing its detection, diagnosis, and quantification, as well as following its subsequent effects on infarct evolution and healing. MO assessment has become a routine component of the CMR evaluation of acute myocardial infarction and will increasingly play a role in clinical trials of adjunctive reperfusion agents and strategies. This review will summarize the pathophysiology of MO, current CMR approaches to diagnosis, clinical implications, and future directions needed for improving our understanding of this common clinical problem.

show abstract

Section: Ongoing Controversies and Future Directionsmentioning

confidence: 99%

CMR of microvascular obstruction and hemorrhage in myocardial infarction

2012

Journal of Cardiovascular Magnetic Resonance

143

144

View full text Add to dashboard Cite

show abstract

“…During PCI such information may not be obtained real-time because the infarct lead(s) may not be monitored. Intracoronary ECG provides a new route to measure both parameters [26], and is certainly suited for posterior (inferobasal) STEMIs where changes are less conspicuous on standard 12-lead ECGs.…”

Section: Complementary Electrocardiographic and Angiographic Informatmentioning

confidence: 99%

Q waves and failed ST resolution: Will intra-myocardial haemorrhage be a concern in reperfusing “late presenting” STEMIs?

Wong

Bucciarelli-Ducci

2015

International Journal of Cardiology

View full text Add to dashboard Cite

“…3,4 Integrated ECG scores facilitate an objective quantification of ECG changes and promote the development of early risk evaluation models. 5 The integrated ST-segment elevation score (ISSTE) is an effective marker of myocardial injury in patients undergoing pPCI and has been associated with in-hospital mortality. 6 Several clinical and angiographic risk stratification systems have been developed for prediction of adverse events and mortality in these patients, without including contemporary laboratory or imaging biomarkers.…”

Section: Introductionmentioning

confidence: 99%

Magnitude of ST-segment Elevation Is Associated with Increased Acute Inflammatory Response and Myocardial Scar in Patients with Acute Myocardial Infarction Undergoing pPCI

Mester

Cernica

Opincariu

et al. 2021

Journal of Cardiovascular Emergencies

View full text Add to dashboard Cite

Background: The integrated ST segment elevation score (ISSTE) score objectively quantifies the ECG changes before and after primary percutaneous coronary intervention (pPCI) for ST segment elevation myocardial infarction (STEMI). The inflammatory response is a major component in scar formation and remodeling process of the myocardial tissue following myocardial infarction (MI). Cardiac magnetic resonance imaging (CMR) precisely quantifies the cardiac function and assesses the pattern of the myocardial scar tissue. The aim of the study was to evaluate the relations between the ISSTE score and: (1) acute inflammatory biomarkers and (2) extent of the myocardial scar determined by CMR in STEMI treated with pPCI. Material and methods: One hundred thirty STEMI patients were included in the study, who underwent pPCI in the first 12 hours from symptom debut. ISSTE-1 was calculated at presentation and 2 hours following pPCI (ISSTE-2). Inflammatory biomarkers were determined at admission and day 5, followed by LGE-CMR at 4 weeks, with quantification of cardiac function and extent of infarct size (IS) and transmurality. Patients were divided in low and high ISSTE groups based on the median values. Results: No significant differences were noted in terms of CMR parameters or inflammatory biomarkers and between the groups with low or high ISSTE-1. Significantly higher levels of day-5 hs-CRP (p = 0.03) and day-1 IL-6 (p = 0.02), MMP-9 (p = 0.05) were recorded in high ISSTE-2 groups. LV IS mass (23.11 ± 5.31 vs. 57.94 ± 8.33, p = 0.001), percentage (13.55 ± 6.22 vs. 27.15 ± 7.12, p = 0.001) and transmurality (p = 0.001) was significantly higher in ISSTE-2 group. ISSTE-2 significantly correlated with LV IS mass (r = 0.391, p <0.0001), percentage (r = 0.541, p <0.0001) high transmurality (r = 0.449, p <0.0001) and LV EF (r = -0.397, p <0.0001). Conclusions: A high ISSTE-2 score is associated with increased inflammatory response exhibited by elevated serum IL-6 and MMP-9 levels determined on the day of admission, and with persistently increased serum hs-CRP levels on day 5 of the acute event. A higher ISSTE-2 score is associated with larger myocardial scar extent expressed by IS, higher transmurality and reduced LV EF at 1-month LGE CMR follow-up.

show abstract

Intracoronary ECG ST‐segment recovery during primary percutaneous intervention for ST‐segment myocardial infarction: Insights from a cardiac MRI study

Abstract: The degree of early IC-STR (defined by IC-STR > 1 mm or <30%) successfully predicts myocardial damage following primary-PCI for an acute STEMI. Further studies are required to investigate its potential utility.

Cited by 5 publications

References 25 publications

CMR of microvascular obstruction and hemorrhage in myocardial infarction

CMR of microvascular obstruction and hemorrhage in myocardial infarction

Q waves and failed ST resolution: Will intra-myocardial haemorrhage be a concern in reperfusing “late presenting” STEMIs?

Magnitude of ST-segment Elevation Is Associated with Increased Acute Inflammatory Response and Myocardial Scar in Patients with Acute Myocardial Infarction Undergoing pPCI

Contact Info

Product

Resources

About