Association Diastolic Function by Echo and Infarct Size by Magnetic Resonance Imaging after STEMI

Helle Søholm, Jacob Lønborg, Mads J Andersen, Niels Vejlstrup, Thomas Engstrøm, Christian Hassager, Jacob Eifer Møller

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

OBJECTIVES: Left ventricular (LV) diastolic dysfunction is a predictor of increased morbidity and mortality, however little is known about diastolic function and the degree of myocardial damage after myocardial infarction (MI). The aim was to assess the association between diastolic dysfunction by echocardiography and myocardial salvage assessed with cardiac magnetic resonance (CMR) imaging in patients with ST-segment elevation MI (STEMI).

DESIGN: In a prospective study, echocardiography and CMR were performed in STEMI-patients in the early post-MI phase assessing diastolic dysfunction according to E/A and E/e'average and area-at-risk, and after 3 months with measurement of final infarct size and salvage index. Linear regression analyses were performed testing the association of diastolic dysfunction with area-at-risk, final infarct size and salvage index.

RESULTS: A total of 193 patients (61±11 years) were included. Median system delay (first medical contact to primary PCI) was 185 min, 123 patients (63%) had TIMI 0/1 flow before intervention, and 85 (46%) sustained an anterior MI. In 74 patients (38%) diastolic function was normal. The presence of diastolic dysfunction was associated with larger area-at-risk of median 6.6% (p < 0.001), larger final infarct size of 4.5% (p < 0.001), and lower salvage index of -5.9% (p=0.02) compared with patients with normal diastolic function.

CONCLUSION: Diastolic dysfunction in the early phase after STEMI is associated with more extensive myocardial damage and significantly poorer myocardial salvage after three months, and the presence of diastolic dysfunction acutely after STEMI may therefore be used as a marker of worse myocardial outcome.

Original languageEnglish
JournalScandinavian Cardiovascular Journal
Volume50
Issue number3
Pages (from-to)172-179
ISSN1401-7431
DOIs
Publication statusPublished - 11. Mar 2016

Fingerprint

Echocardiography
Linear Models
Regression Analysis
Prospective Studies
ST Elevation Myocardial Infarction

Cite this

Søholm, Helle ; Lønborg, Jacob ; Andersen, Mads J ; Vejlstrup, Niels ; Engstrøm, Thomas ; Hassager, Christian ; Møller, Jacob Eifer. / Association Diastolic Function by Echo and Infarct Size by Magnetic Resonance Imaging after STEMI. In: Scandinavian Cardiovascular Journal. 2016 ; Vol. 50, No. 3. pp. 172-179.
@article{979e701122bd4a7186c81e30b2f57632,
title = "Association Diastolic Function by Echo and Infarct Size by Magnetic Resonance Imaging after STEMI",
abstract = "OBJECTIVES: Left ventricular (LV) diastolic dysfunction is a predictor of increased morbidity and mortality, however little is known about diastolic function and the degree of myocardial damage after myocardial infarction (MI). The aim was to assess the association between diastolic dysfunction by echocardiography and myocardial salvage assessed with cardiac magnetic resonance (CMR) imaging in patients with ST-segment elevation MI (STEMI).DESIGN: In a prospective study, echocardiography and CMR were performed in STEMI-patients in the early post-MI phase assessing diastolic dysfunction according to E/A and E/e'average and area-at-risk, and after 3 months with measurement of final infarct size and salvage index. Linear regression analyses were performed testing the association of diastolic dysfunction with area-at-risk, final infarct size and salvage index.RESULTS: A total of 193 patients (61±11 years) were included. Median system delay (first medical contact to primary PCI) was 185 min, 123 patients (63{\%}) had TIMI 0/1 flow before intervention, and 85 (46{\%}) sustained an anterior MI. In 74 patients (38{\%}) diastolic function was normal. The presence of diastolic dysfunction was associated with larger area-at-risk of median 6.6{\%} (p < 0.001), larger final infarct size of 4.5{\%} (p < 0.001), and lower salvage index of -5.9{\%} (p=0.02) compared with patients with normal diastolic function.CONCLUSION: Diastolic dysfunction in the early phase after STEMI is associated with more extensive myocardial damage and significantly poorer myocardial salvage after three months, and the presence of diastolic dysfunction acutely after STEMI may therefore be used as a marker of worse myocardial outcome.",
author = "Helle S{\o}holm and Jacob L{\o}nborg and Andersen, {Mads J} and Niels Vejlstrup and Thomas Engstr{\o}m and Christian Hassager and M{\o}ller, {Jacob Eifer}",
year = "2016",
month = "3",
day = "11",
doi = "10.3109/14017431.2016.1163416",
language = "English",
volume = "50",
pages = "172--179",
journal = "Scandinavian Cardiovascular Journal",
issn = "1401-7431",
publisher = "Taylor & Francis",
number = "3",

}

Association Diastolic Function by Echo and Infarct Size by Magnetic Resonance Imaging after STEMI. / Søholm, Helle; Lønborg, Jacob; Andersen, Mads J; Vejlstrup, Niels; Engstrøm, Thomas; Hassager, Christian ; Møller, Jacob Eifer.

In: Scandinavian Cardiovascular Journal, Vol. 50, No. 3, 11.03.2016, p. 172-179.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Association Diastolic Function by Echo and Infarct Size by Magnetic Resonance Imaging after STEMI

AU - Søholm, Helle

AU - Lønborg, Jacob

AU - Andersen, Mads J

AU - Vejlstrup, Niels

AU - Engstrøm, Thomas

AU - Hassager, Christian

AU - Møller, Jacob Eifer

PY - 2016/3/11

Y1 - 2016/3/11

N2 - OBJECTIVES: Left ventricular (LV) diastolic dysfunction is a predictor of increased morbidity and mortality, however little is known about diastolic function and the degree of myocardial damage after myocardial infarction (MI). The aim was to assess the association between diastolic dysfunction by echocardiography and myocardial salvage assessed with cardiac magnetic resonance (CMR) imaging in patients with ST-segment elevation MI (STEMI).DESIGN: In a prospective study, echocardiography and CMR were performed in STEMI-patients in the early post-MI phase assessing diastolic dysfunction according to E/A and E/e'average and area-at-risk, and after 3 months with measurement of final infarct size and salvage index. Linear regression analyses were performed testing the association of diastolic dysfunction with area-at-risk, final infarct size and salvage index.RESULTS: A total of 193 patients (61±11 years) were included. Median system delay (first medical contact to primary PCI) was 185 min, 123 patients (63%) had TIMI 0/1 flow before intervention, and 85 (46%) sustained an anterior MI. In 74 patients (38%) diastolic function was normal. The presence of diastolic dysfunction was associated with larger area-at-risk of median 6.6% (p < 0.001), larger final infarct size of 4.5% (p < 0.001), and lower salvage index of -5.9% (p=0.02) compared with patients with normal diastolic function.CONCLUSION: Diastolic dysfunction in the early phase after STEMI is associated with more extensive myocardial damage and significantly poorer myocardial salvage after three months, and the presence of diastolic dysfunction acutely after STEMI may therefore be used as a marker of worse myocardial outcome.

AB - OBJECTIVES: Left ventricular (LV) diastolic dysfunction is a predictor of increased morbidity and mortality, however little is known about diastolic function and the degree of myocardial damage after myocardial infarction (MI). The aim was to assess the association between diastolic dysfunction by echocardiography and myocardial salvage assessed with cardiac magnetic resonance (CMR) imaging in patients with ST-segment elevation MI (STEMI).DESIGN: In a prospective study, echocardiography and CMR were performed in STEMI-patients in the early post-MI phase assessing diastolic dysfunction according to E/A and E/e'average and area-at-risk, and after 3 months with measurement of final infarct size and salvage index. Linear regression analyses were performed testing the association of diastolic dysfunction with area-at-risk, final infarct size and salvage index.RESULTS: A total of 193 patients (61±11 years) were included. Median system delay (first medical contact to primary PCI) was 185 min, 123 patients (63%) had TIMI 0/1 flow before intervention, and 85 (46%) sustained an anterior MI. In 74 patients (38%) diastolic function was normal. The presence of diastolic dysfunction was associated with larger area-at-risk of median 6.6% (p < 0.001), larger final infarct size of 4.5% (p < 0.001), and lower salvage index of -5.9% (p=0.02) compared with patients with normal diastolic function.CONCLUSION: Diastolic dysfunction in the early phase after STEMI is associated with more extensive myocardial damage and significantly poorer myocardial salvage after three months, and the presence of diastolic dysfunction acutely after STEMI may therefore be used as a marker of worse myocardial outcome.

U2 - 10.3109/14017431.2016.1163416

DO - 10.3109/14017431.2016.1163416

M3 - Journal article

VL - 50

SP - 172

EP - 179

JO - Scandinavian Cardiovascular Journal

JF - Scandinavian Cardiovascular Journal

SN - 1401-7431

IS - 3

ER -