Publicação
Myocardial perfusion grade after late infarct artery recanalization is associated with global and regional left ventricular function at one year: analysis from the Total Occlusion Study of Canada-2.
| Resumo: | BACKGROUND: Whether myocardial perfusion grade (MPG) following late recanalization of infarct-related arteries (IRAs) predicts left ventricular (LV) function recovery beyond the acute phase of myocardial infarction (MI) is unknown. METHODS AND RESULTS: The Total Occlusion Study of Canada-2 enrolled stable patients with a persistently occluded IRA beyond 24 hours and up to 28 days post-MI. We studied the relationship between the initial MPG and changes in LV function and volume as well as the change in MPG from immediate post-percutaneous coronary intervention (PCI) to 1 year in 139 PCI patients with thrombolysis in myocardial infarction grade 3 epicardial flow post-PCI and with paired values grouped into impaired or good MPG groups (MPG 0/1 or MPG 2/3). MPG 0/1 patients were more likely to have received thrombolytic therapy and to have a left anterior descending IRA. They had lower blood pressure and LV ejection fraction (LVEF) and a higher heart rate and systolic sphericity index at baseline. Changes in the MPG 0/1 and MPG 2/3 groups from baseline to 1 year were LVEF, 3.3±9.0% and 4.8±8.9% (P=0.42); LV end-systolic volume index (LVESVI), -1.1±9.2 and -4.7±12.3 mL/m(2) (P=0.25); LV end-diastolic volume index (LVEDVI), 0.08±19.1 and -2.4±22.2 mL/m(2) (P=0.67); and SDs/chord for infarct zone wall motion index (WMI), 0.38±0.70 and 0.84±1.11 (P=0.01). By covariate-adjusted analysis, post-PCI MPG 0/1 predicted lower WMI (P<0.001), lower LVEF (P<0.001), and higher LVESVI (P<0.01) but not LVEDVI at 1 year. Of the MPG 0/1 patients, 60% were MPG 2 or 3 at 1 year. CONCLUSIONS: Preserved MPG is present in a high proportion of patients following late PCI of occluded IRAs post-MI. Poor MPG post-PCI frequently improves MPG over 1 year. MPG graded after IRA recanalization undertaken days to weeks post MI is associated with LV recovery, indicating that MPG determined in the subacute post-MI period remains a marker of viability. |
|---|---|
| Autores principais: | Steigen, T |
| Outros Autores: | Christopher, E; Buller, C; Mancini, G; Jorapur, V; Cantor, W; Rankin, J; Thomas, B; Webb, J; Kronsberg, S; Atchison, D; Lamas, G; Hochman, J; Dzavík, V |
| Assunto: | Acute coronary syndrome Myocardial infarction Angioplasty |
| Ano: | 2010 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Hospital Prof. Dr. Fernando Fonseca E.P.E. |
| Idioma: | inglês |
| Origem: | Repositório do Hospital Prof. Doutor Fernando Fonseca |
| _version_ | 1868417262042480640 |
|---|---|
| author | Steigen, T |
| author2 | Christopher, E Buller, C Mancini, G Jorapur, V Cantor, W Rankin, J Thomas, B Webb, J Kronsberg, S Atchison, D Lamas, G Hochman, J Dzavík, V |
| author2_role | author author author author author author author author author author author author author |
| author_facet | Steigen, T Christopher, E Buller, C Mancini, G Jorapur, V Cantor, W Rankin, J Thomas, B Webb, J Kronsberg, S Atchison, D Lamas, G Hochman, J Dzavík, V |
| author_role | author |
| contributor_name_str_mv | Unidade Local de Saúde Amadora / Sintra |
| country_str | PT |
| creators_json_txt | [{\"Person.name\":\"Steigen, T\"},{\"Person.name\":\"Christopher, E\"},{\"Person.name\":\"Buller, C\"},{\"Person.name\":\"Mancini, G\"},{\"Person.name\":\"Jorapur, V\"},{\"Person.name\":\"Cantor, W\"},{\"Person.name\":\"Rankin, J\"},{\"Person.name\":\"Thomas, B\"},{\"Person.name\":\"Webb, J\"},{\"Person.name\":\"Kronsberg, S\"},{\"Person.name\":\"Atchison, D\"},{\"Person.name\":\"Lamas, G\"},{\"Person.name\":\"Hochman, J\"},{\"Person.name\":\"Dzavík, V\"}] |
| datacite.contributors.contributor.contributorName.fl_str_mv | Unidade Local de Saúde Amadora / Sintra |
| datacite.creators.creator.creatorName.fl_str_mv | Steigen, T Christopher, E Buller, C Mancini, G Jorapur, V Cantor, W Rankin, J Thomas, B Webb, J Kronsberg, S Atchison, D Lamas, G Hochman, J Dzavík, V |
| datacite.date.Accepted.fl_str_mv | 2010-01-01T00:00:00Z |
| datacite.date.available.fl_str_mv | 2012-12-20T12:40:45Z |
| datacite.date.embargoed.fl_str_mv | 2012-12-20T12:40:45Z |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| datacite.subjects.subject.fl_str_mv | Acute coronary syndrome Myocardial infarction Angioplasty |
| datacite.titles.title.fl_str_mv | Myocardial perfusion grade after late infarct artery recanalization is associated with global and regional left ventricular function at one year: analysis from the Total Occlusion Study of Canada-2. |
| dc.contributor.none.fl_str_mv | Unidade Local de Saúde Amadora / Sintra |
| dc.creator.none.fl_str_mv | Steigen, T Christopher, E Buller, C Mancini, G Jorapur, V Cantor, W Rankin, J Thomas, B Webb, J Kronsberg, S Atchison, D Lamas, G Hochman, J Dzavík, V |
| dc.date.Accepted.fl_str_mv | 2010-01-01T00:00:00Z |
| dc.date.available.fl_str_mv | 2012-12-20T12:40:45Z |
| dc.date.embargoed.fl_str_mv | 2012-12-20T12:40:45Z |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://hdl.handle.net/10400.10/823 |
| dc.language.none.fl_str_mv | eng |
| dc.publisher.none.fl_str_mv | Lippincott Williams & Wilkins |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| dc.subject.none.fl_str_mv | Acute coronary syndrome Myocardial infarction Angioplasty |
| dc.title.fl_str_mv | Myocardial perfusion grade after late infarct artery recanalization is associated with global and regional left ventricular function at one year: analysis from the Total Occlusion Study of Canada-2. |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_6501 |
| description | BACKGROUND: Whether myocardial perfusion grade (MPG) following late recanalization of infarct-related arteries (IRAs) predicts left ventricular (LV) function recovery beyond the acute phase of myocardial infarction (MI) is unknown. METHODS AND RESULTS: The Total Occlusion Study of Canada-2 enrolled stable patients with a persistently occluded IRA beyond 24 hours and up to 28 days post-MI. We studied the relationship between the initial MPG and changes in LV function and volume as well as the change in MPG from immediate post-percutaneous coronary intervention (PCI) to 1 year in 139 PCI patients with thrombolysis in myocardial infarction grade 3 epicardial flow post-PCI and with paired values grouped into impaired or good MPG groups (MPG 0/1 or MPG 2/3). MPG 0/1 patients were more likely to have received thrombolytic therapy and to have a left anterior descending IRA. They had lower blood pressure and LV ejection fraction (LVEF) and a higher heart rate and systolic sphericity index at baseline. Changes in the MPG 0/1 and MPG 2/3 groups from baseline to 1 year were LVEF, 3.3±9.0% and 4.8±8.9% (P=0.42); LV end-systolic volume index (LVESVI), -1.1±9.2 and -4.7±12.3 mL/m(2) (P=0.25); LV end-diastolic volume index (LVEDVI), 0.08±19.1 and -2.4±22.2 mL/m(2) (P=0.67); and SDs/chord for infarct zone wall motion index (WMI), 0.38±0.70 and 0.84±1.11 (P=0.01). By covariate-adjusted analysis, post-PCI MPG 0/1 predicted lower WMI (P<0.001), lower LVEF (P<0.001), and higher LVESVI (P<0.01) but not LVEDVI at 1 year. Of the MPG 0/1 patients, 60% were MPG 2 or 3 at 1 year. CONCLUSIONS: Preserved MPG is present in a high proportion of patients following late PCI of occluded IRAs post-MI. Poor MPG post-PCI frequently improves MPG over 1 year. MPG graded after IRA recanalization undertaken days to weeks post MI is associated with LV recovery, indicating that MPG determined in the subacute post-MI period remains a marker of viability. |
| dirty | 0 |
| eu_rights_str_mv | openAccess |
| format | article |
| fulltext.url.fl_str_mv | https://repositorio.hff.min-saude.pt/bitstreams/69634c44-b637-4463-9f97-83e37a4a737b/download |
| id | rhff_fa7a9ab77aefb0807e4aafff0932f7d2 |
| identifier.url.fl_str_mv | http://hdl.handle.net/10400.10/823 |
| instacron_str | hff |
| institution | Hospital Prof. Dr. Fernando Fonseca E.P.E. |
| instname_str | Hospital Prof. Dr. Fernando Fonseca E.P.E. |
| language | eng |
| network_acronym_str | rhff |
| network_name_str | Repositório do Hospital Prof. Doutor Fernando Fonseca |
| oai_identifier_str | oai:repositorio.hff.min-saude.pt:10400.10/823 |
| organization_str_mv | urn:organizationAcronym:hff |
| person_str_mv | Steigen, T Christopher, E Buller, C Mancini, G Jorapur, V Cantor, W Rankin, J Thomas, B Webb, J Kronsberg, S Atchison, D Lamas, G Hochman, J Dzavík, V |
| publishDate | 2010 |
| publisher.none.fl_str_mv | Lippincott Williams & Wilkins |
| reponame_str | Repositório do Hospital Prof. Doutor Fernando Fonseca |
| repository_id_str | urn:repositoryAcronym:rhff |
| service_str_mv | urn:repositoryAcronym:rhff |
| spelling | engLippincott Williams & WilkinsporBACKGROUND: Whether myocardial perfusion grade (MPG) following late recanalization of infarct-related arteries (IRAs) predicts left ventricular (LV) function recovery beyond the acute phase of myocardial infarction (MI) is unknown. METHODS AND RESULTS: The Total Occlusion Study of Canada-2 enrolled stable patients with a persistently occluded IRA beyond 24 hours and up to 28 days post-MI. We studied the relationship between the initial MPG and changes in LV function and volume as well as the change in MPG from immediate post-percutaneous coronary intervention (PCI) to 1 year in 139 PCI patients with thrombolysis in myocardial infarction grade 3 epicardial flow post-PCI and with paired values grouped into impaired or good MPG groups (MPG 0/1 or MPG 2/3). MPG 0/1 patients were more likely to have received thrombolytic therapy and to have a left anterior descending IRA. They had lower blood pressure and LV ejection fraction (LVEF) and a higher heart rate and systolic sphericity index at baseline. Changes in the MPG 0/1 and MPG 2/3 groups from baseline to 1 year were LVEF, 3.3±9.0% and 4.8±8.9% (P=0.42); LV end-systolic volume index (LVESVI), -1.1±9.2 and -4.7±12.3 mL/m(2) (P=0.25); LV end-diastolic volume index (LVEDVI), 0.08±19.1 and -2.4±22.2 mL/m(2) (P=0.67); and SDs/chord for infarct zone wall motion index (WMI), 0.38±0.70 and 0.84±1.11 (P=0.01). By covariate-adjusted analysis, post-PCI MPG 0/1 predicted lower WMI (P<0.001), lower LVEF (P<0.001), and higher LVESVI (P<0.01) but not LVEDVI at 1 year. Of the MPG 0/1 patients, 60% were MPG 2 or 3 at 1 year. CONCLUSIONS: Preserved MPG is present in a high proportion of patients following late PCI of occluded IRAs post-MI. Poor MPG post-PCI frequently improves MPG over 1 year. MPG graded after IRA recanalization undertaken days to weeks post MI is associated with LV recovery, indicating that MPG determined in the subacute post-MI period remains a marker of viability.application/pdfporMyocardial perfusion grade after late infarct artery recanalization is associated with global and regional left ventricular function at one year: analysis from the Total Occlusion Study of Canada-2.Steigen, TChristopher, EBuller, CMancini, GJorapur, VCantor, WRankin, JThomas, BWebb, JKronsberg, SAtchison, DLamas, GHochman, JDzavík, VHostingInstitutionOrganizationalUnidade Local de Saúde Amadora / Sintrae-mailmailto:repositorio@hff.min-saude.ptrepositorio@hff.min-saude.ptISSNIsPartOf1941-76322012-12-20T12:40:45Z20102010-01-01T00:00:00ZHandlehttp://hdl.handle.net/10400.10/823http://purl.org/coar/access_right/c_abf2open accessAcute coronary syndromeMyocardial infarctionAngioplasty141612 bytesliteraturehttp://purl.org/coar/resource_type/c_6501journal articlehttp://purl.org/coar/access_right/c_abf2application/pdffulltexthttps://repositorio.hff.min-saude.pt/bitstreams/69634c44-b637-4463-9f97-83e37a4a737b/downloadCirculation. Cardiovascular Interventions3549555Hagerstown |
| spellingShingle | Myocardial perfusion grade after late infarct artery recanalization is associated with global and regional left ventricular function at one year: analysis from the Total Occlusion Study of Canada-2. Steigen, T Acute coronary syndrome Myocardial infarction Angioplasty |
| status | SINGLETON |
| subject.fl_str_mv | Acute coronary syndrome Myocardial infarction Angioplasty |
| title | Myocardial perfusion grade after late infarct artery recanalization is associated with global and regional left ventricular function at one year: analysis from the Total Occlusion Study of Canada-2. |
| title_full | Myocardial perfusion grade after late infarct artery recanalization is associated with global and regional left ventricular function at one year: analysis from the Total Occlusion Study of Canada-2. |
| title_fullStr | Myocardial perfusion grade after late infarct artery recanalization is associated with global and regional left ventricular function at one year: analysis from the Total Occlusion Study of Canada-2. |
| title_full_unstemmed | Myocardial perfusion grade after late infarct artery recanalization is associated with global and regional left ventricular function at one year: analysis from the Total Occlusion Study of Canada-2. |
| title_short | Myocardial perfusion grade after late infarct artery recanalization is associated with global and regional left ventricular function at one year: analysis from the Total Occlusion Study of Canada-2. |
| title_sort | Myocardial perfusion grade after late infarct artery recanalization is associated with global and regional left ventricular function at one year: analysis from the Total Occlusion Study of Canada-2. |
| topic | Acute coronary syndrome Myocardial infarction Angioplasty |
| topic_facet | Acute coronary syndrome Myocardial infarction Angioplasty |
| url | http://hdl.handle.net/10400.10/823 |
| visible | 1 |