Abstract

LLUBERAS, Natalia; PARMA, Gabriel; FLORIO, Lucía  and  ZAMORANO, José Luis. Asociación entre la resolución del ST con la obstrucción microvascular y el tamaño del infarto evaluado mediante resonancia magnética cardíaca. Rev.Urug.Cardiol. [online]. 2012, vol.27, n.1, pp.17-27. ISSN 1688-0420.

Introduction and aims: the absence of ST-segment resolution (STR) in patients with an ST-elevation myocardial infarction (STEMI) after reperfusion strategy has been related to impaired myocardial perfusion. This is likely due to extensive microvascular obstruction (MVO) and reperfusion tissue injury. The aim of the study was to analyze the value of STR in the prediction of infarct size, perfusion impairment and left ventricular function assessed with cardiac magnetic resonance (CMR) in acute STEMI. Methods: 33 reperfused STEMI patients who had undergone a CMR in the early phase were studied. STR at 90 minutes was analyzed and categorized in two subgroups: ³ 50% y <50%. Different CMR parameters were analyzed: final volumes, LVEF, infarct size and presence and extent of microvascular obstruction. Results: in the group withSTR (n = 19), infarct size, the rate of perfusion defect and end-systolic volume index of LV were significantly lower than in the group without STR. The presence of OMV was significantly related to the absence of STR (p = 0,01) but not with TIMI flow and myocardial blush. Of all the clinical, electrocardiographic and angiographic variables, the RST was the strongest parameter to predict the extent of MVO in the infarct area (b = -0,488, P = 0,004) and LVEF (b = 0,39, p = 0,02). Conclusion: in patients with STEMI, the STR is an independent predictor of the extent of the OMV in the area of infarction and of LVEF. These findings highlight the usefulness of the RST assessment in patients with reperfused STEMI

Keywords :  MIOCARDIAL INFARCTION; MAGNETIC RESONANCE; VENTRICULAR FUNCTION, LEFT.

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