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Prognostic importance of acute phase extracellular volume evaluated by cardiac magnetic resonance imaging for patients with acute myocardial infarction

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Abstract

Myocardial extracellular volume (ECV) by cardiac magnetic resonance (CMR) in the acute phase of acute myocardial infarction (MI) more precisely predicts the functional recovery of infarct-related wall motion abnormalities and left ventricular (LV) remodeling than late gadolinium enhancement (LGE). The purpose of this study was to evaluate the prognostic importance of acute phase ECV in patients with AMI. We evaluated 61 consecutive AMI patients using 3.0 T CMR. CMR examination was performed median 10 days (7–15 days) after PCI. Primary endpoint was defined as major adverse cardiac event (MACE). The median follow-up duration was 3.1 years, and MACE occurred in 11 (18%) patients. Although LVEF and % infarct LGE volume were not associated with MACE in this study population, higher infarct ECV predicted the MACE with a hazard ratio (HR) of 4.04 (P = 0.02). High global ECV, which was a combined assessment of infarct ECV and remote ECV, also predicted MACE with a HR of 5.24 (P = 0.035). The addition of infarct ECV to remote ECV (global chi-squared score: 1.4) resulted in a significantly increased global chi-squared score (6.7; P = 0.017). Furthermore, after adjusting for the calculated propensity score for high global ECV, it remained an independent predictor of MACE with HR of 5.10 (P = 0.04). The quantification of ECV in the acute phase among AMI patients may provide an incremental prognostic value for predicting MACE beyond that of clinical, angiographic, and functional variables.

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The data underlying this article will be shared on reasonable request to the corresponding author.

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This research used only commercially available software.

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Authors and Affiliations

  1. Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan

    Masaki Ishiyama, Tairo Kurita, Taku Omori, Shiro Nakamori, Naoki Fujimoto & Masaaki Ito

  2. Department of Radiology, Mie University Graduate School of Medicine, Tsu, Japan

    Satoshi Nakamura, Masaki Ishida, Kakuya Kitagawa, Hajime Sakuma & Kaoru Dohi

Authors
  1. Masaki Ishiyama
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  2. Tairo Kurita
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  4. Taku Omori
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Correspondence to Tairo Kurita.

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Ethical approval

This study was approved by the Mie University Hospital Institutional Review Board (Reference number H2019-071).

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All patients provided written informed consent or opt-out informed consent. All patients provided opt-out informed consent for publication.

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Ishiyama, M., Kurita, T., Nakamura, S. et al. Prognostic importance of acute phase extracellular volume evaluated by cardiac magnetic resonance imaging for patients with acute myocardial infarction. Int J Cardiovasc Imaging 37, 3285–3297 (2021). https://doi.org/10.1007/s10554-021-02321-0

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