Impact of Primary Coronary Angioplasty Delay on Myocardial Salvage, Infarct Size, and Microvascular Damage in Patients With ST-Segment Elevation Myocardial InfarctionInsight From Cardiovascular Magnetic Resonance
Marco Francone, MD, PhD, MSc*,
Chiara Bucciarelli-Ducci, MD , ,
Iacopo Carbone, MD*,
Emanuele Canali, MD,
Raffaele Scardala, MD,
Francesca A. Calabrese, MD*,
Gennaro Sardella, MD ,
Massimo Mancone, MD,
Carlo Catalano, MD*,
Francesco Fedele, MD,
Roberto Passariello, MD*,
Jan Bogaert, MD, PhD|| and
Luciano Agati, MD,*
* Cardiovascular Magnetic Resonance Unit, Department of Radiology Sciences, "Sapienza" University of Rome, Rome, Italy
Cardiac Imaging Unit and Cardiovascular Division, "Sapienza" University of Rome, Rome, Italy
Catheterization Laboratory, Department of Cardiology Sciences, "Sapienza" University of Rome, Rome, Italy
Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, United Kingdom
|| Department of Medical Imaging, Gasthuisberg University Hospital, Leuven, Belgium
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Figure 1 Time to Reperfusion and Cardiovascular Magnetic Resonance Parameters
Bar graphs show the influence of time to reperfusion on infarct size (A), myocardial edema (B), myocardial salvage (C), and microvascular obstruction (MVO) (D). Data are expressed as % left ventricular mass.
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Figure 3 Influence of Time to Reperfusion on Myocardial Salvage
(A) Influence of time to reperfusion on myocardial edema and infarct size in inferior myocardial infarctions. Temporal distribution of myocardial edema and infarct size among the 4 groups in patients with inferior myocardial infarction. (Top) T2-weighted short tau inversion recovery (T2w-STIR) images; (bottom) corresponding late gadolinium enhancement (LGE) images. As time to reperfusion progresses, infarct size (thin arrows) and microvascular obstruction (MVO) (*) increase. Of note, in group I (early reperfused) the area of edema (open arrows) largely exceeds the area of infarct size, demonstrating presence of myocardial salvage; conversely in group IV (reperfused the latest), the area of edema almost corresponds to the infarcted area, suggesting limited myocardial salvage. (B) Influence of time to reperfusion on myocardial edema and infarct size in anterior myocardial infarctions. Temporal distribution of myocardial edema and infarct size among the 4 groups in patients with anterior myocardial infarction. (Top) T2w-STIR images; (bottom) corresponding LGE images. As time to reperfusion progresses, infarct size (thin arrows) and MVO (*) increase, with a parallel myocardial salvage reduction.
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