Residual ischemia location after STEMI by CMR and association with non-culprit coronary artery disease
Abstract Background Many ST-segment elevation myocardial infarction (STEMI) patients present with non-culprit coronary artery disease. In cases with incomplete revascularization, stress cardiac magnetic resonance (sCMR) could help detect and locate residual ischemia. Purpose We aim to evaluate the u...
Gespeichert in:
| Veröffentlicht in: | European heart journal 2024-10, Vol.45 (Supplement_1) |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | Supplement_1 |
| container_start_page | |
| container_title | European heart journal |
| container_volume | 45 |
| creator | Iraola-Viana, D Marcos Garces, V Merenciano-Gonzalez, H Gavara, J Monmeneu, J V Lopez-Lereu, M P Perez, N Rios-Navarro, C De Dios, E Bertolin-Boronat, C Moratal, D Minana, G Nunez, J Sanchis, J Bodi, V |
| description | Abstract
Background
Many ST-segment elevation myocardial infarction (STEMI) patients present with non-culprit coronary artery disease. In cases with incomplete revascularization, stress cardiac magnetic resonance (sCMR) could help detect and locate residual ischemia.
Purpose
We aim to evaluate the usefulness of sCMR to detect and locate residual ischemia in STEMI patients after discharge and correlate the findings with angiographical non-culprit coronary lesions, if any.
Methods
Reperfused, stable STEMI patients submitted to undergo sCMR within the first year after STEMI were included in the cohort. Index coronary angiography was revised, culprit and non-culprit coronary artery disease were registered, and significant stenoses were defined as ≥50% by visual assessment. Residual ischemia on sCMR (by first-pass vasodilator stress perfusion) was analysed and categorized as either absent or present in anterior, lateral, and inferior territories. Unrevascularized non-culprit coronary lesions were correlated with territories with residual ischemia on sCMR and lesions in subsequent coronary angiography. A p-value |
| doi_str_mv | 10.1093/eurheartj/ehae666.219 |
| format | Article |
| fullrecord | <record><control><sourceid>oup_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1093_eurheartj_ehae666_219</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/eurheartj/ehae666.219</oup_id><sourcerecordid>10.1093/eurheartj/ehae666.219</sourcerecordid><originalsourceid>FETCH-LOGICAL-c879-40cbe602186532cc9b95c8cc05409dd784d9e2cd1d1266b75ec68cda87eb75f43</originalsourceid><addsrcrecordid>eNqNkNFKwzAUhoMoOKePIOQFuiVZkyaXMqYONoS5C-9KenJKM7pmJC2yt7ey4bVXPwfO9_PzEfLM2Ywzs5jjEBu0sT_MsbGolJoJbm7IhEshMqNyeUsmjBuZKaW_7slDSgfGmFZcTUi9w-TdYFvqEzR49Ja2AWzvQ0dt3WOkn_vVdk2rM11ud9R2jtqUAvjLy7fvG9qFLoOhPUXfUwgxdDae6bgHx3A-oU34SO5q2yZ8uuaU7F9X--V7tvl4Wy9fNhnowmQ5gwoVE1wruRAApjISNACTOTPOFTp3BgU47rhQqiokgtLgrC5wPOp8MSXyUgsxpBSxLsdRx3FOyVn566r8c1VeXZWjq5FjFy4Mp38iPy0Vc8I</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Residual ischemia location after STEMI by CMR and association with non-culprit coronary artery disease</title><source>OUP_牛津大学出版社现刊</source><creator>Iraola-Viana, D ; Marcos Garces, V ; Merenciano-Gonzalez, H ; Gavara, J ; Monmeneu, J V ; Lopez-Lereu, M P ; Perez, N ; Rios-Navarro, C ; De Dios, E ; Bertolin-Boronat, C ; Moratal, D ; Minana, G ; Nunez, J ; Sanchis, J ; Bodi, V</creator><creatorcontrib>Iraola-Viana, D ; Marcos Garces, V ; Merenciano-Gonzalez, H ; Gavara, J ; Monmeneu, J V ; Lopez-Lereu, M P ; Perez, N ; Rios-Navarro, C ; De Dios, E ; Bertolin-Boronat, C ; Moratal, D ; Minana, G ; Nunez, J ; Sanchis, J ; Bodi, V</creatorcontrib><description>Abstract
Background
Many ST-segment elevation myocardial infarction (STEMI) patients present with non-culprit coronary artery disease. In cases with incomplete revascularization, stress cardiac magnetic resonance (sCMR) could help detect and locate residual ischemia.
Purpose
We aim to evaluate the usefulness of sCMR to detect and locate residual ischemia in STEMI patients after discharge and correlate the findings with angiographical non-culprit coronary lesions, if any.
Methods
Reperfused, stable STEMI patients submitted to undergo sCMR within the first year after STEMI were included in the cohort. Index coronary angiography was revised, culprit and non-culprit coronary artery disease were registered, and significant stenoses were defined as ≥50% by visual assessment. Residual ischemia on sCMR (by first-pass vasodilator stress perfusion) was analysed and categorized as either absent or present in anterior, lateral, and inferior territories. Unrevascularized non-culprit coronary lesions were correlated with territories with residual ischemia on sCMR and lesions in subsequent coronary angiography. A p-value <0.05 was considered statistically significant.
Results
The study group was made up of 234 patients who underwent sCMR within the first year after STEMI (mean age 58.95±11.85 years, 78.2% male, 48.7% anterior infarction). Residual ischemia by sCMR was noted in 63 (26.9%) patients. In the 95 patients (40.6%) who underwent complete revascularization during index admission, residual ischemia by sCMR was seldom detected (n=14, 14.7%) and distributed on anterior (n=8), lateral (n=3) and inferior (n=4) territories. More than half of the cohort (n=139, 59.4%) depicted unrevascularized non-culprit coronary lesions, and residual ischemia was detected in 49 (35.3%) patients. Non-culprit lesions on left anterior descendent artery (n=62) associated with ischemia in 38.7% of cases (n=24), most commonly in the anterior territory (n=17, 70.8%). Similar findings were noted for lesions on circumflex artery (n=66), which depicted residual ischemia in 34.8% (n=23) of cases and most frequently in the lateral territory (n=13, 56.5%); and lesions in right coronary artery (n=45), which depicted residual ischemia in 42.2% (n=19) of cases, most commonly in the inferior territory (n=13, 68.4%). Significant coronary stenosis was found in most patients who underwent subsequent coronary angiography after residual ischemia detection (41 out of 47, 87.2%).
Conclusions
One third of STEMI patients with incomplete revascularization and non-culprit coronary artery disease depict residual ischemia on sCMR, the location of which generally correlates with index coronary anatomy and significant stenosis in subsequent coronary angiography. Residual ischemia is infrequent in patients with complete revascularization, but not inexistent. sCMR should be considered in selected STEMI patients according to coronary anatomy and/or symptoms to guide therapy.Stress CMR and ischemia location</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehae666.219</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><ispartof>European heart journal, 2024-10, Vol.45 (Supplement_1)</ispartof><rights>The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com. 2024</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Iraola-Viana, D</creatorcontrib><creatorcontrib>Marcos Garces, V</creatorcontrib><creatorcontrib>Merenciano-Gonzalez, H</creatorcontrib><creatorcontrib>Gavara, J</creatorcontrib><creatorcontrib>Monmeneu, J V</creatorcontrib><creatorcontrib>Lopez-Lereu, M P</creatorcontrib><creatorcontrib>Perez, N</creatorcontrib><creatorcontrib>Rios-Navarro, C</creatorcontrib><creatorcontrib>De Dios, E</creatorcontrib><creatorcontrib>Bertolin-Boronat, C</creatorcontrib><creatorcontrib>Moratal, D</creatorcontrib><creatorcontrib>Minana, G</creatorcontrib><creatorcontrib>Nunez, J</creatorcontrib><creatorcontrib>Sanchis, J</creatorcontrib><creatorcontrib>Bodi, V</creatorcontrib><title>Residual ischemia location after STEMI by CMR and association with non-culprit coronary artery disease</title><title>European heart journal</title><description>Abstract
Background
Many ST-segment elevation myocardial infarction (STEMI) patients present with non-culprit coronary artery disease. In cases with incomplete revascularization, stress cardiac magnetic resonance (sCMR) could help detect and locate residual ischemia.
Purpose
We aim to evaluate the usefulness of sCMR to detect and locate residual ischemia in STEMI patients after discharge and correlate the findings with angiographical non-culprit coronary lesions, if any.
Methods
Reperfused, stable STEMI patients submitted to undergo sCMR within the first year after STEMI were included in the cohort. Index coronary angiography was revised, culprit and non-culprit coronary artery disease were registered, and significant stenoses were defined as ≥50% by visual assessment. Residual ischemia on sCMR (by first-pass vasodilator stress perfusion) was analysed and categorized as either absent or present in anterior, lateral, and inferior territories. Unrevascularized non-culprit coronary lesions were correlated with territories with residual ischemia on sCMR and lesions in subsequent coronary angiography. A p-value <0.05 was considered statistically significant.
Results
The study group was made up of 234 patients who underwent sCMR within the first year after STEMI (mean age 58.95±11.85 years, 78.2% male, 48.7% anterior infarction). Residual ischemia by sCMR was noted in 63 (26.9%) patients. In the 95 patients (40.6%) who underwent complete revascularization during index admission, residual ischemia by sCMR was seldom detected (n=14, 14.7%) and distributed on anterior (n=8), lateral (n=3) and inferior (n=4) territories. More than half of the cohort (n=139, 59.4%) depicted unrevascularized non-culprit coronary lesions, and residual ischemia was detected in 49 (35.3%) patients. Non-culprit lesions on left anterior descendent artery (n=62) associated with ischemia in 38.7% of cases (n=24), most commonly in the anterior territory (n=17, 70.8%). Similar findings were noted for lesions on circumflex artery (n=66), which depicted residual ischemia in 34.8% (n=23) of cases and most frequently in the lateral territory (n=13, 56.5%); and lesions in right coronary artery (n=45), which depicted residual ischemia in 42.2% (n=19) of cases, most commonly in the inferior territory (n=13, 68.4%). Significant coronary stenosis was found in most patients who underwent subsequent coronary angiography after residual ischemia detection (41 out of 47, 87.2%).
Conclusions
One third of STEMI patients with incomplete revascularization and non-culprit coronary artery disease depict residual ischemia on sCMR, the location of which generally correlates with index coronary anatomy and significant stenosis in subsequent coronary angiography. Residual ischemia is infrequent in patients with complete revascularization, but not inexistent. sCMR should be considered in selected STEMI patients according to coronary anatomy and/or symptoms to guide therapy.Stress CMR and ischemia location</description><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNqNkNFKwzAUhoMoOKePIOQFuiVZkyaXMqYONoS5C-9KenJKM7pmJC2yt7ey4bVXPwfO9_PzEfLM2Ywzs5jjEBu0sT_MsbGolJoJbm7IhEshMqNyeUsmjBuZKaW_7slDSgfGmFZcTUi9w-TdYFvqEzR49Ja2AWzvQ0dt3WOkn_vVdk2rM11ud9R2jtqUAvjLy7fvG9qFLoOhPUXfUwgxdDae6bgHx3A-oU34SO5q2yZ8uuaU7F9X--V7tvl4Wy9fNhnowmQ5gwoVE1wruRAApjISNACTOTPOFTp3BgU47rhQqiokgtLgrC5wPOp8MSXyUgsxpBSxLsdRx3FOyVn566r8c1VeXZWjq5FjFy4Mp38iPy0Vc8I</recordid><startdate>20241028</startdate><enddate>20241028</enddate><creator>Iraola-Viana, D</creator><creator>Marcos Garces, V</creator><creator>Merenciano-Gonzalez, H</creator><creator>Gavara, J</creator><creator>Monmeneu, J V</creator><creator>Lopez-Lereu, M P</creator><creator>Perez, N</creator><creator>Rios-Navarro, C</creator><creator>De Dios, E</creator><creator>Bertolin-Boronat, C</creator><creator>Moratal, D</creator><creator>Minana, G</creator><creator>Nunez, J</creator><creator>Sanchis, J</creator><creator>Bodi, V</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20241028</creationdate><title>Residual ischemia location after STEMI by CMR and association with non-culprit coronary artery disease</title><author>Iraola-Viana, D ; Marcos Garces, V ; Merenciano-Gonzalez, H ; Gavara, J ; Monmeneu, J V ; Lopez-Lereu, M P ; Perez, N ; Rios-Navarro, C ; De Dios, E ; Bertolin-Boronat, C ; Moratal, D ; Minana, G ; Nunez, J ; Sanchis, J ; Bodi, V</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c879-40cbe602186532cc9b95c8cc05409dd784d9e2cd1d1266b75ec68cda87eb75f43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Iraola-Viana, D</creatorcontrib><creatorcontrib>Marcos Garces, V</creatorcontrib><creatorcontrib>Merenciano-Gonzalez, H</creatorcontrib><creatorcontrib>Gavara, J</creatorcontrib><creatorcontrib>Monmeneu, J V</creatorcontrib><creatorcontrib>Lopez-Lereu, M P</creatorcontrib><creatorcontrib>Perez, N</creatorcontrib><creatorcontrib>Rios-Navarro, C</creatorcontrib><creatorcontrib>De Dios, E</creatorcontrib><creatorcontrib>Bertolin-Boronat, C</creatorcontrib><creatorcontrib>Moratal, D</creatorcontrib><creatorcontrib>Minana, G</creatorcontrib><creatorcontrib>Nunez, J</creatorcontrib><creatorcontrib>Sanchis, J</creatorcontrib><creatorcontrib>Bodi, V</creatorcontrib><collection>CrossRef</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Iraola-Viana, D</au><au>Marcos Garces, V</au><au>Merenciano-Gonzalez, H</au><au>Gavara, J</au><au>Monmeneu, J V</au><au>Lopez-Lereu, M P</au><au>Perez, N</au><au>Rios-Navarro, C</au><au>De Dios, E</au><au>Bertolin-Boronat, C</au><au>Moratal, D</au><au>Minana, G</au><au>Nunez, J</au><au>Sanchis, J</au><au>Bodi, V</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Residual ischemia location after STEMI by CMR and association with non-culprit coronary artery disease</atitle><jtitle>European heart journal</jtitle><date>2024-10-28</date><risdate>2024</risdate><volume>45</volume><issue>Supplement_1</issue><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>Abstract
Background
Many ST-segment elevation myocardial infarction (STEMI) patients present with non-culprit coronary artery disease. In cases with incomplete revascularization, stress cardiac magnetic resonance (sCMR) could help detect and locate residual ischemia.
Purpose
We aim to evaluate the usefulness of sCMR to detect and locate residual ischemia in STEMI patients after discharge and correlate the findings with angiographical non-culprit coronary lesions, if any.
Methods
Reperfused, stable STEMI patients submitted to undergo sCMR within the first year after STEMI were included in the cohort. Index coronary angiography was revised, culprit and non-culprit coronary artery disease were registered, and significant stenoses were defined as ≥50% by visual assessment. Residual ischemia on sCMR (by first-pass vasodilator stress perfusion) was analysed and categorized as either absent or present in anterior, lateral, and inferior territories. Unrevascularized non-culprit coronary lesions were correlated with territories with residual ischemia on sCMR and lesions in subsequent coronary angiography. A p-value <0.05 was considered statistically significant.
Results
The study group was made up of 234 patients who underwent sCMR within the first year after STEMI (mean age 58.95±11.85 years, 78.2% male, 48.7% anterior infarction). Residual ischemia by sCMR was noted in 63 (26.9%) patients. In the 95 patients (40.6%) who underwent complete revascularization during index admission, residual ischemia by sCMR was seldom detected (n=14, 14.7%) and distributed on anterior (n=8), lateral (n=3) and inferior (n=4) territories. More than half of the cohort (n=139, 59.4%) depicted unrevascularized non-culprit coronary lesions, and residual ischemia was detected in 49 (35.3%) patients. Non-culprit lesions on left anterior descendent artery (n=62) associated with ischemia in 38.7% of cases (n=24), most commonly in the anterior territory (n=17, 70.8%). Similar findings were noted for lesions on circumflex artery (n=66), which depicted residual ischemia in 34.8% (n=23) of cases and most frequently in the lateral territory (n=13, 56.5%); and lesions in right coronary artery (n=45), which depicted residual ischemia in 42.2% (n=19) of cases, most commonly in the inferior territory (n=13, 68.4%). Significant coronary stenosis was found in most patients who underwent subsequent coronary angiography after residual ischemia detection (41 out of 47, 87.2%).
Conclusions
One third of STEMI patients with incomplete revascularization and non-culprit coronary artery disease depict residual ischemia on sCMR, the location of which generally correlates with index coronary anatomy and significant stenosis in subsequent coronary angiography. Residual ischemia is infrequent in patients with complete revascularization, but not inexistent. sCMR should be considered in selected STEMI patients according to coronary anatomy and/or symptoms to guide therapy.Stress CMR and ischemia location</abstract><cop>US</cop><pub>Oxford University Press</pub><doi>10.1093/eurheartj/ehae666.219</doi></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0195-668X |
| ispartof | European heart journal, 2024-10, Vol.45 (Supplement_1) |
| issn | 0195-668X 1522-9645 |
| language | eng |
| recordid | cdi_crossref_primary_10_1093_eurheartj_ehae666_219 |
| source | OUP_牛津大学出版社现刊 |
| title | Residual ischemia location after STEMI by CMR and association with non-culprit coronary artery disease |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-28T07%3A47%3A54IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-oup_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Residual%20ischemia%20location%20after%20STEMI%20by%20CMR%20and%20association%20with%20non-culprit%20coronary%20artery%20disease&rft.jtitle=European%20heart%20journal&rft.au=Iraola-Viana,%20D&rft.date=2024-10-28&rft.volume=45&rft.issue=Supplement_1&rft.issn=0195-668X&rft.eissn=1522-9645&rft_id=info:doi/10.1093/eurheartj/ehae666.219&rft_dat=%3Coup_cross%3E10.1093/eurheartj/ehae666.219%3C/oup_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/&rft_oup_id=10.1093/eurheartj/ehae666.219&rfr_iscdi=true |