Cardiac computed tomography for prediction of myocardial viability after reperfused acute myocardial infarction

Michael Shapiro, Ammar Sarwar, Koen Nieman, Khurram Nasir, Thomas J. Brady, Ricardo C. Cury

    Research output: Contribution to journalArticle

    13 Citations (Scopus)

    Abstract

    Background: Perfusion defects (PDs) detected with cardiac magnetic resonance (CMR) imaging predict the functional recovery of myocardial function after acute myocardial infarction. Objective: We evaluated the ability of cardiac computed tomography (CCT) to predict the recovery of regional left ventricular (LV) systolic function after ST elevation myocardial infarction (STEMI). Methods: Seventeen patients (mean age, 60 ± 10 years) presenting with STEMI were prospectively studied. Each patient underwent CCT and CMR at baseline and after an average of 6 months. Areas of PD were quantified. Segmental LV systolic function was semiquantitatively assessed by CMR. An improvement at 6 months by ≥1 category in the regional wall motion score was considered LV recovery. Results: Coronary artery revascularization was successfully performed with postprocedural TIMI 3 flow in 16 cases. On CCT assessment, 107 of 289 segments (37%) had some degree of PD. On follow-up, segments with 75% PD, 89% (9 of 11) showed akinesis or worsening of wall motion. The odds ratio for improvement in segmental wall motion with increasing PD category was 0.63 (95% CI, 0.42-0.97; P = 0.035). The degree of PD on CT predicted LV recovery at follow-up (P <0.0001). Conclusions: The transmural extent of myocardial infarction as detected and quantified with CCT predicts the recovery of regional systolic LV function after revascularization for acute STEMI.

    Original languageEnglish (US)
    Pages (from-to)267-273
    Number of pages7
    JournalJournal of Cardiovascular Computed Tomography
    Volume4
    Issue number4
    DOIs
    StatePublished - Jul 2010

    Fingerprint

    Perfusion
    Myocardial Infarction
    Tomography
    Left Ventricular Function
    Magnetic Resonance Spectroscopy
    Recovery of Function
    Coronary Vessels
    Odds Ratio
    Magnetic Resonance Imaging
    ST Elevation Myocardial Infarction

    Keywords

    • Magnetic resonance imaging
    • Multidetector computed tomography
    • Myocardial infarction
    • Revascularization
    • Viability

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine
    • Radiology Nuclear Medicine and imaging
    • Medicine(all)

    Cite this

    Cardiac computed tomography for prediction of myocardial viability after reperfused acute myocardial infarction. / Shapiro, Michael; Sarwar, Ammar; Nieman, Koen; Nasir, Khurram; Brady, Thomas J.; Cury, Ricardo C.

    In: Journal of Cardiovascular Computed Tomography, Vol. 4, No. 4, 07.2010, p. 267-273.

    Research output: Contribution to journalArticle

    Shapiro, Michael ; Sarwar, Ammar ; Nieman, Koen ; Nasir, Khurram ; Brady, Thomas J. ; Cury, Ricardo C. / Cardiac computed tomography for prediction of myocardial viability after reperfused acute myocardial infarction. In: Journal of Cardiovascular Computed Tomography. 2010 ; Vol. 4, No. 4. pp. 267-273.
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    abstract = "Background: Perfusion defects (PDs) detected with cardiac magnetic resonance (CMR) imaging predict the functional recovery of myocardial function after acute myocardial infarction. Objective: We evaluated the ability of cardiac computed tomography (CCT) to predict the recovery of regional left ventricular (LV) systolic function after ST elevation myocardial infarction (STEMI). Methods: Seventeen patients (mean age, 60 ± 10 years) presenting with STEMI were prospectively studied. Each patient underwent CCT and CMR at baseline and after an average of 6 months. Areas of PD were quantified. Segmental LV systolic function was semiquantitatively assessed by CMR. An improvement at 6 months by ≥1 category in the regional wall motion score was considered LV recovery. Results: Coronary artery revascularization was successfully performed with postprocedural TIMI 3 flow in 16 cases. On CCT assessment, 107 of 289 segments (37{\%}) had some degree of PD. On follow-up, segments with 75{\%} PD, 89{\%} (9 of 11) showed akinesis or worsening of wall motion. The odds ratio for improvement in segmental wall motion with increasing PD category was 0.63 (95{\%} CI, 0.42-0.97; P = 0.035). The degree of PD on CT predicted LV recovery at follow-up (P <0.0001). Conclusions: The transmural extent of myocardial infarction as detected and quantified with CCT predicts the recovery of regional systolic LV function after revascularization for acute STEMI.",
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    N2 - Background: Perfusion defects (PDs) detected with cardiac magnetic resonance (CMR) imaging predict the functional recovery of myocardial function after acute myocardial infarction. Objective: We evaluated the ability of cardiac computed tomography (CCT) to predict the recovery of regional left ventricular (LV) systolic function after ST elevation myocardial infarction (STEMI). Methods: Seventeen patients (mean age, 60 ± 10 years) presenting with STEMI were prospectively studied. Each patient underwent CCT and CMR at baseline and after an average of 6 months. Areas of PD were quantified. Segmental LV systolic function was semiquantitatively assessed by CMR. An improvement at 6 months by ≥1 category in the regional wall motion score was considered LV recovery. Results: Coronary artery revascularization was successfully performed with postprocedural TIMI 3 flow in 16 cases. On CCT assessment, 107 of 289 segments (37%) had some degree of PD. On follow-up, segments with 75% PD, 89% (9 of 11) showed akinesis or worsening of wall motion. The odds ratio for improvement in segmental wall motion with increasing PD category was 0.63 (95% CI, 0.42-0.97; P = 0.035). The degree of PD on CT predicted LV recovery at follow-up (P <0.0001). Conclusions: The transmural extent of myocardial infarction as detected and quantified with CCT predicts the recovery of regional systolic LV function after revascularization for acute STEMI.

    AB - Background: Perfusion defects (PDs) detected with cardiac magnetic resonance (CMR) imaging predict the functional recovery of myocardial function after acute myocardial infarction. Objective: We evaluated the ability of cardiac computed tomography (CCT) to predict the recovery of regional left ventricular (LV) systolic function after ST elevation myocardial infarction (STEMI). Methods: Seventeen patients (mean age, 60 ± 10 years) presenting with STEMI were prospectively studied. Each patient underwent CCT and CMR at baseline and after an average of 6 months. Areas of PD were quantified. Segmental LV systolic function was semiquantitatively assessed by CMR. An improvement at 6 months by ≥1 category in the regional wall motion score was considered LV recovery. Results: Coronary artery revascularization was successfully performed with postprocedural TIMI 3 flow in 16 cases. On CCT assessment, 107 of 289 segments (37%) had some degree of PD. On follow-up, segments with 75% PD, 89% (9 of 11) showed akinesis or worsening of wall motion. The odds ratio for improvement in segmental wall motion with increasing PD category was 0.63 (95% CI, 0.42-0.97; P = 0.035). The degree of PD on CT predicted LV recovery at follow-up (P <0.0001). Conclusions: The transmural extent of myocardial infarction as detected and quantified with CCT predicts the recovery of regional systolic LV function after revascularization for acute STEMI.

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