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Prognostic implication of global myocardial blood flow in patients with ST-segment elevation myocardial infarction
The prognostic implications of cardiovascular magnetic resonance imaging (CMR)-derived hyperemic myocardial blood flow (MBF) in patients with ST-elevation myocardial infarction (STEMI) are unknown. This study sought to investigate the incremental prognostic value of hyperemic MBF over conventional C...
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| Published in: | Heart and vessels 2020-07, Vol.35 (7), p.936-945 |
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| creator | Hamaya, Rikuta Kanaji, Yoshihisa Hada, Masahiro Kanno, Yoshinori Usui, Eisuke Hoshino, Masahiro Yamaguchi, Masao Sumino, Yohei Horie, Tomoki Hirano, Hidenori Sugiyama, Tomoyo Kakuta, Tsunekazu |
| description | The prognostic implications of cardiovascular magnetic resonance imaging (CMR)-derived hyperemic myocardial blood flow (MBF) in patients with ST-elevation myocardial infarction (STEMI) are unknown. This study sought to investigate the incremental prognostic value of hyperemic MBF over conventional CMR markers to identify patients with high risk of future incidence of patient-oriented composite outcomes (POCO) and major adverse cardiac events (MACE) after STEMI. A total of 237 patients who presented with STEMI were prospectively enrolled. The CMR protocol included left-ventricular ejection fraction (LVEF), late gadolinium enhancement (LGE) and microvascular obstruction (MVO) measurement, and volumetric MBF assessment. During a median follow-up of 2.6 years, 47 patients experienced POCO (primary outcome) and 21 patients had MACE. In a multivariable model, multivessel disease, LGE, MVO, and hyperemic MBF were independently associated with POCO. Addition of hyperemic MBF to the model consisting of GRACE score, multivessel disease, LVEF, LGE, and MVO significantly improved the predictive efficacy (integrated discrimination improvement 0.020,
p
= 0.021). Patients with low hyperemic MBF had significantly higher incidence of MACE compared to those with high hyperemic MBF in propensity score matching analysis (
p
= 0.018). In conclusion, CMR-derived hyperemic MBF could provide independent and incremental prognostic value over LVEF, LGE, and MVO in patients with STEMI. |
| doi_str_mv | 10.1007/s00380-020-01570-8 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2366641925</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2366641925</sourcerecordid><originalsourceid>FETCH-LOGICAL-c399t-2a001b4e79fe4477491ab4e172469a0397be00112acff7396fe8a6eac8945a0b3</originalsourceid><addsrcrecordid>eNp9kUtPGzEUha2qqITQP8ACWeqGzbR-zXi8RFEplZCoRFhbHscOjjzjYE-K-Pe96aQUsUDy8_o7x1c6CJ1R8pUSIr8VQnhLKsJg0lqSqv2AZrShdcVqyT-iGVEUipzJY3RSyoYApaj6hI45o4TDMkP5V07rIZUxWBz6bQzWjCENOHm8jqkzEffPyZq8CnDsYkor7GN6wmHAWyDdMBb8FMYHfLesilv3UMAuut-TyyttGLzJdl89RUfexOI-H_Y5ur_6vlxcVze3P34uLm8qy5UaK2ag3044qbwTQkqhqIErlUw0yhCuZOeAoMxY7yVXjXetaZyxrRK1IR2fo4vJd5vT486VUfehWBejGVzaFc140zSCKlYD-uUNukm7PEB3mgkiGyJgAMUmyuZUSnZeb3PoTX7WlOh9InpKREMi-m8iugXR-cF61_Vu9SL5FwEAfAIKPA1rl____Y7tH67Tl0g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2407604604</pqid></control><display><type>article</type><title>Prognostic implication of global myocardial blood flow in patients with ST-segment elevation myocardial infarction</title><source>Springer Nature</source><creator>Hamaya, Rikuta ; Kanaji, Yoshihisa ; Hada, Masahiro ; Kanno, Yoshinori ; Usui, Eisuke ; Hoshino, Masahiro ; Yamaguchi, Masao ; Sumino, Yohei ; Horie, Tomoki ; Hirano, Hidenori ; Sugiyama, Tomoyo ; Kakuta, Tsunekazu</creator><creatorcontrib>Hamaya, Rikuta ; Kanaji, Yoshihisa ; Hada, Masahiro ; Kanno, Yoshinori ; Usui, Eisuke ; Hoshino, Masahiro ; Yamaguchi, Masao ; Sumino, Yohei ; Horie, Tomoki ; Hirano, Hidenori ; Sugiyama, Tomoyo ; Kakuta, Tsunekazu</creatorcontrib><description>The prognostic implications of cardiovascular magnetic resonance imaging (CMR)-derived hyperemic myocardial blood flow (MBF) in patients with ST-elevation myocardial infarction (STEMI) are unknown. This study sought to investigate the incremental prognostic value of hyperemic MBF over conventional CMR markers to identify patients with high risk of future incidence of patient-oriented composite outcomes (POCO) and major adverse cardiac events (MACE) after STEMI. A total of 237 patients who presented with STEMI were prospectively enrolled. The CMR protocol included left-ventricular ejection fraction (LVEF), late gadolinium enhancement (LGE) and microvascular obstruction (MVO) measurement, and volumetric MBF assessment. During a median follow-up of 2.6 years, 47 patients experienced POCO (primary outcome) and 21 patients had MACE. In a multivariable model, multivessel disease, LGE, MVO, and hyperemic MBF were independently associated with POCO. Addition of hyperemic MBF to the model consisting of GRACE score, multivessel disease, LVEF, LGE, and MVO significantly improved the predictive efficacy (integrated discrimination improvement 0.020,
p
= 0.021). Patients with low hyperemic MBF had significantly higher incidence of MACE compared to those with high hyperemic MBF in propensity score matching analysis (
p
= 0.018). In conclusion, CMR-derived hyperemic MBF could provide independent and incremental prognostic value over LVEF, LGE, and MVO in patients with STEMI.</description><identifier>ISSN: 0910-8327</identifier><identifier>EISSN: 1615-2573</identifier><identifier>DOI: 10.1007/s00380-020-01570-8</identifier><identifier>PMID: 32103321</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Aged ; Biomedical Engineering and Bioengineering ; Blood flow ; Cardiac Surgery ; Cardiology ; Coronary Circulation ; Coronary Sinus - diagnostic imaging ; Coronary Sinus - physiopathology ; Female ; Gadolinium ; Heart ; Heart attacks ; Heart Disease Risk Factors ; Humans ; Hyperemia - diagnostic imaging ; Hyperemia - physiopathology ; Magnetic resonance imaging ; Magnetic Resonance Imaging, Cine ; Male ; Medicine ; Medicine & Public Health ; Microvasculature ; Middle Aged ; Myocardial infarction ; Myocardial Perfusion Imaging ; Original Article ; Percutaneous Coronary Intervention ; Predictive Value of Tests ; Reproducibility of Results ; Retrospective Studies ; Risk Assessment ; ST Elevation Myocardial Infarction - diagnostic imaging ; ST Elevation Myocardial Infarction - physiopathology ; ST Elevation Myocardial Infarction - therapy ; Stents ; Treatment Outcome ; Vascular Surgery ; Ventricle</subject><ispartof>Heart and vessels, 2020-07, Vol.35 (7), p.936-945</ispartof><rights>Springer Japan KK, part of Springer Nature 2020</rights><rights>Springer Japan KK, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c399t-2a001b4e79fe4477491ab4e172469a0397be00112acff7396fe8a6eac8945a0b3</citedby><cites>FETCH-LOGICAL-c399t-2a001b4e79fe4477491ab4e172469a0397be00112acff7396fe8a6eac8945a0b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,27911,27912</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32103321$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hamaya, Rikuta</creatorcontrib><creatorcontrib>Kanaji, Yoshihisa</creatorcontrib><creatorcontrib>Hada, Masahiro</creatorcontrib><creatorcontrib>Kanno, Yoshinori</creatorcontrib><creatorcontrib>Usui, Eisuke</creatorcontrib><creatorcontrib>Hoshino, Masahiro</creatorcontrib><creatorcontrib>Yamaguchi, Masao</creatorcontrib><creatorcontrib>Sumino, Yohei</creatorcontrib><creatorcontrib>Horie, Tomoki</creatorcontrib><creatorcontrib>Hirano, Hidenori</creatorcontrib><creatorcontrib>Sugiyama, Tomoyo</creatorcontrib><creatorcontrib>Kakuta, Tsunekazu</creatorcontrib><title>Prognostic implication of global myocardial blood flow in patients with ST-segment elevation myocardial infarction</title><title>Heart and vessels</title><addtitle>Heart Vessels</addtitle><addtitle>Heart Vessels</addtitle><description>The prognostic implications of cardiovascular magnetic resonance imaging (CMR)-derived hyperemic myocardial blood flow (MBF) in patients with ST-elevation myocardial infarction (STEMI) are unknown. This study sought to investigate the incremental prognostic value of hyperemic MBF over conventional CMR markers to identify patients with high risk of future incidence of patient-oriented composite outcomes (POCO) and major adverse cardiac events (MACE) after STEMI. A total of 237 patients who presented with STEMI were prospectively enrolled. The CMR protocol included left-ventricular ejection fraction (LVEF), late gadolinium enhancement (LGE) and microvascular obstruction (MVO) measurement, and volumetric MBF assessment. During a median follow-up of 2.6 years, 47 patients experienced POCO (primary outcome) and 21 patients had MACE. In a multivariable model, multivessel disease, LGE, MVO, and hyperemic MBF were independently associated with POCO. Addition of hyperemic MBF to the model consisting of GRACE score, multivessel disease, LVEF, LGE, and MVO significantly improved the predictive efficacy (integrated discrimination improvement 0.020,
p
= 0.021). Patients with low hyperemic MBF had significantly higher incidence of MACE compared to those with high hyperemic MBF in propensity score matching analysis (
p
= 0.018). In conclusion, CMR-derived hyperemic MBF could provide independent and incremental prognostic value over LVEF, LGE, and MVO in patients with STEMI.</description><subject>Aged</subject><subject>Biomedical Engineering and Bioengineering</subject><subject>Blood flow</subject><subject>Cardiac Surgery</subject><subject>Cardiology</subject><subject>Coronary Circulation</subject><subject>Coronary Sinus - diagnostic imaging</subject><subject>Coronary Sinus - physiopathology</subject><subject>Female</subject><subject>Gadolinium</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Heart Disease Risk Factors</subject><subject>Humans</subject><subject>Hyperemia - diagnostic imaging</subject><subject>Hyperemia - physiopathology</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging, Cine</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Microvasculature</subject><subject>Middle Aged</subject><subject>Myocardial infarction</subject><subject>Myocardial Perfusion Imaging</subject><subject>Original Article</subject><subject>Percutaneous Coronary Intervention</subject><subject>Predictive Value of Tests</subject><subject>Reproducibility of Results</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>ST Elevation Myocardial Infarction - diagnostic imaging</subject><subject>ST Elevation Myocardial Infarction - physiopathology</subject><subject>ST Elevation Myocardial Infarction - therapy</subject><subject>Stents</subject><subject>Treatment Outcome</subject><subject>Vascular Surgery</subject><subject>Ventricle</subject><issn>0910-8327</issn><issn>1615-2573</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kUtPGzEUha2qqITQP8ACWeqGzbR-zXi8RFEplZCoRFhbHscOjjzjYE-K-Pe96aQUsUDy8_o7x1c6CJ1R8pUSIr8VQnhLKsJg0lqSqv2AZrShdcVqyT-iGVEUipzJY3RSyoYApaj6hI45o4TDMkP5V07rIZUxWBz6bQzWjCENOHm8jqkzEffPyZq8CnDsYkor7GN6wmHAWyDdMBb8FMYHfLesilv3UMAuut-TyyttGLzJdl89RUfexOI-H_Y5ur_6vlxcVze3P34uLm8qy5UaK2ag3044qbwTQkqhqIErlUw0yhCuZOeAoMxY7yVXjXetaZyxrRK1IR2fo4vJd5vT486VUfehWBejGVzaFc140zSCKlYD-uUNukm7PEB3mgkiGyJgAMUmyuZUSnZeb3PoTX7WlOh9InpKREMi-m8iugXR-cF61_Vu9SL5FwEAfAIKPA1rl____Y7tH67Tl0g</recordid><startdate>20200701</startdate><enddate>20200701</enddate><creator>Hamaya, Rikuta</creator><creator>Kanaji, Yoshihisa</creator><creator>Hada, Masahiro</creator><creator>Kanno, Yoshinori</creator><creator>Usui, Eisuke</creator><creator>Hoshino, Masahiro</creator><creator>Yamaguchi, Masao</creator><creator>Sumino, Yohei</creator><creator>Horie, Tomoki</creator><creator>Hirano, Hidenori</creator><creator>Sugiyama, Tomoyo</creator><creator>Kakuta, Tsunekazu</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20200701</creationdate><title>Prognostic implication of global myocardial blood flow in patients with ST-segment elevation myocardial infarction</title><author>Hamaya, Rikuta ; Kanaji, Yoshihisa ; Hada, Masahiro ; Kanno, Yoshinori ; Usui, Eisuke ; Hoshino, Masahiro ; Yamaguchi, Masao ; Sumino, Yohei ; Horie, Tomoki ; Hirano, Hidenori ; Sugiyama, Tomoyo ; Kakuta, Tsunekazu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c399t-2a001b4e79fe4477491ab4e172469a0397be00112acff7396fe8a6eac8945a0b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Biomedical Engineering and Bioengineering</topic><topic>Blood flow</topic><topic>Cardiac Surgery</topic><topic>Cardiology</topic><topic>Coronary Circulation</topic><topic>Coronary Sinus - diagnostic imaging</topic><topic>Coronary Sinus - physiopathology</topic><topic>Female</topic><topic>Gadolinium</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Heart Disease Risk Factors</topic><topic>Humans</topic><topic>Hyperemia - diagnostic imaging</topic><topic>Hyperemia - physiopathology</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging, Cine</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Microvasculature</topic><topic>Middle Aged</topic><topic>Myocardial infarction</topic><topic>Myocardial Perfusion Imaging</topic><topic>Original Article</topic><topic>Percutaneous Coronary Intervention</topic><topic>Predictive Value of Tests</topic><topic>Reproducibility of Results</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>ST Elevation Myocardial Infarction - diagnostic imaging</topic><topic>ST Elevation Myocardial Infarction - physiopathology</topic><topic>ST Elevation Myocardial Infarction - therapy</topic><topic>Stents</topic><topic>Treatment Outcome</topic><topic>Vascular Surgery</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hamaya, Rikuta</creatorcontrib><creatorcontrib>Kanaji, Yoshihisa</creatorcontrib><creatorcontrib>Hada, Masahiro</creatorcontrib><creatorcontrib>Kanno, Yoshinori</creatorcontrib><creatorcontrib>Usui, Eisuke</creatorcontrib><creatorcontrib>Hoshino, Masahiro</creatorcontrib><creatorcontrib>Yamaguchi, Masao</creatorcontrib><creatorcontrib>Sumino, Yohei</creatorcontrib><creatorcontrib>Horie, Tomoki</creatorcontrib><creatorcontrib>Hirano, Hidenori</creatorcontrib><creatorcontrib>Sugiyama, Tomoyo</creatorcontrib><creatorcontrib>Kakuta, Tsunekazu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Heart and vessels</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hamaya, Rikuta</au><au>Kanaji, Yoshihisa</au><au>Hada, Masahiro</au><au>Kanno, Yoshinori</au><au>Usui, Eisuke</au><au>Hoshino, Masahiro</au><au>Yamaguchi, Masao</au><au>Sumino, Yohei</au><au>Horie, Tomoki</au><au>Hirano, Hidenori</au><au>Sugiyama, Tomoyo</au><au>Kakuta, Tsunekazu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic implication of global myocardial blood flow in patients with ST-segment elevation myocardial infarction</atitle><jtitle>Heart and vessels</jtitle><stitle>Heart Vessels</stitle><addtitle>Heart Vessels</addtitle><date>2020-07-01</date><risdate>2020</risdate><volume>35</volume><issue>7</issue><spage>936</spage><epage>945</epage><pages>936-945</pages><issn>0910-8327</issn><eissn>1615-2573</eissn><abstract>The prognostic implications of cardiovascular magnetic resonance imaging (CMR)-derived hyperemic myocardial blood flow (MBF) in patients with ST-elevation myocardial infarction (STEMI) are unknown. This study sought to investigate the incremental prognostic value of hyperemic MBF over conventional CMR markers to identify patients with high risk of future incidence of patient-oriented composite outcomes (POCO) and major adverse cardiac events (MACE) after STEMI. A total of 237 patients who presented with STEMI were prospectively enrolled. The CMR protocol included left-ventricular ejection fraction (LVEF), late gadolinium enhancement (LGE) and microvascular obstruction (MVO) measurement, and volumetric MBF assessment. During a median follow-up of 2.6 years, 47 patients experienced POCO (primary outcome) and 21 patients had MACE. In a multivariable model, multivessel disease, LGE, MVO, and hyperemic MBF were independently associated with POCO. Addition of hyperemic MBF to the model consisting of GRACE score, multivessel disease, LVEF, LGE, and MVO significantly improved the predictive efficacy (integrated discrimination improvement 0.020,
p
= 0.021). Patients with low hyperemic MBF had significantly higher incidence of MACE compared to those with high hyperemic MBF in propensity score matching analysis (
p
= 0.018). In conclusion, CMR-derived hyperemic MBF could provide independent and incremental prognostic value over LVEF, LGE, and MVO in patients with STEMI.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>32103321</pmid><doi>10.1007/s00380-020-01570-8</doi><tpages>10</tpages></addata></record> |
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| subjects | Aged Biomedical Engineering and Bioengineering Blood flow Cardiac Surgery Cardiology Coronary Circulation Coronary Sinus - diagnostic imaging Coronary Sinus - physiopathology Female Gadolinium Heart Heart attacks Heart Disease Risk Factors Humans Hyperemia - diagnostic imaging Hyperemia - physiopathology Magnetic resonance imaging Magnetic Resonance Imaging, Cine Male Medicine Medicine & Public Health Microvasculature Middle Aged Myocardial infarction Myocardial Perfusion Imaging Original Article Percutaneous Coronary Intervention Predictive Value of Tests Reproducibility of Results Retrospective Studies Risk Assessment ST Elevation Myocardial Infarction - diagnostic imaging ST Elevation Myocardial Infarction - physiopathology ST Elevation Myocardial Infarction - therapy Stents Treatment Outcome Vascular Surgery Ventricle |
| title | Prognostic implication of global myocardial blood flow in patients with ST-segment elevation myocardial infarction |
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