Cardiovascular magnetic resonance imaging-derived intraventricular pressure gradients in ST-segment elevation myocardial infarction : a long-term follow-up study
Konijnenberg, Lara S F. (Radboud University Medical Center (Holanda))
Beijnink, Casper W H. (Radboud University Medical Center (Holanda))
van Lieshout, Maarten (Radboud University Medical Center (Holanda))
Vos, Jacqueline L. (Radboud University Medical Center (Holanda))
Rodwell, Laura (Radboud University Medical Center (Holanda))
Bodi, Vicente (Universitat de València. Departament de Medicina)
Ortiz-Pérez, José T. (Hospital Clínic i Provincial de Barcelona)
van Royen, Niels (Radboud University Medical Center (Holanda))
Rodríguez Palomares, José Fernando (Vall d'Hebron Institut de Recerca (VHIR))
Nijveldt, Robin (Radboud University Medical Center (Holanda))

Data:	2024
Resum:	Recently, novel post-processing tools have become available that measure intraventricular pressure gradients (IVPGs) on routinely obtained long-axis cine cardiac magnetic resonance (CMR) images. IVPGs provide a comprehensive overview of both systolic and diastolic left ventricular (LV) functions. Whether IVPGs are associated with clinical outcome after ST-elevation myocardial infarction (STEMI) is currently unknown. Here, we investigated the association between CMR-derived LV-IVPGs and major adverse cardiovascular events (MACE) in a large reperfused STEMI cohort with long-term outcome. In this prospectively enrolled multi-centre cohort study, 307 patients underwent CMR within 14 days after the first STEMI. LV-IVPGs (from apex-to-base) were estimated on the long-axis cine images. During a median follow-up of 9. 7 (5. 9-12. 5) years, MACE (i. e. composite of cardiovascular death and de novo heart failure hospitalisation) occurred in 49 patients (16. 0%). These patients had larger infarcts, more often microvascular injury, and impaired LV-IVPGs. In univariable Cox regression, overall LV-IVPG was significantly associated with MACE and remained significantly associated after adjustment for common clinical risk factors (hazard ratio (HR) 0. 873, 95% confidence interval (CI) 0. 794-0. 961, P = 0. 005) and myocardial injury parameters (HR 0. 906, 95% CI 0. 825-0. 995, P = 0. 038). However, adjusted for LV ejection fraction and LV global longitudinal strain (GLS), overall LV-IVPG does not provide additional prognostic information (HR 0. 959, 95% CI 0. 866-1. 063, P = 0. 426). Early after STEMI, CMR-derived LV-IVPGs are univariably associated with MACE and this association remains significant after adjustment for common clinical risk factors and measures of infarct severity. However, LV-IVPGs do not add prognostic value to LV ejection fraction and LV GLS.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	ST-elevation myocardial infarction ; Cardiac magnetic resonance imaging ; Microvascular injury ; Feature tracking ; Intraventricular pressure gradients
Publicat a:	European Heart Journal. Imaging Methods and Practice, Vol. 2 (february 2024) , ISSN 2755-9637

DOI: 10.1093/ehjimp/qyae009
PMID: 39045208

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