Mitral regurgitation quantified by CMR 4D-flow is associated with microvascular obstruction post reperfused ST-segment elevation myocardial infarction

Assadi, Hosamadin ORCID: https://orcid.org/0000-0002-6143-8095, Grafton-Clarke, Ciaran ORCID: https://orcid.org/0000-0002-8537-0806, Demirkiran, Ahmet, van der Geest, Rob J., Nijveldt, Robin, Flather, Marcus, Swift, Andrew J., Vassiliou, Vassilios ORCID: https://orcid.org/0000-0002-4005-7752, Swoboda, Peter P., Dastidar, Amardeep, Greenwood, John P., Plein, Sven and Garg, Pankaj ORCID: https://orcid.org/0000-0002-5483-169X (2022) Mitral regurgitation quantified by CMR 4D-flow is associated with microvascular obstruction post reperfused ST-segment elevation myocardial infarction. BMC Research Notes, 15. ISSN 1756-0500

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Abstract

Objectives: Mitral regurgitation (MR) and microvascular obstruction (MVO) are common complications of myocardial infarction (MI). This study aimed to investigate the association between MR in ST-elevation MI (STEMI) subjects with MVO post-reperfusion. STEMI subjects undergoing primary percutaneous intervention were enrolled. Cardiovascular magnetic resonance (CMR) imaging was performed within 48-hours of initial presentation. 4D flow images of CMR were analysed using a retrospective valve tracking technique to quantify MR volume, and late gadolinium enhancement images of CMR to assess MVO.  Results: Among 69 patients in the study cohort, 41 had MVO (59%). Patients with MVO had lower left ventricular (LV) ejection fraction (EF) (42 ± 10% vs. 52 ± 8%, P < 0.01), higher end-systolic volume (98 ± 49 ml vs. 73 ± 28 ml, P < 0.001) and larger scar volume (26 ± 19% vs. 11 ± 9%, P < 0.001). Extent of MVO was associated with the degree of MR quantified by 4D flow (R = 0.54, P = 0.0003). In uni-variate regression analysis, investigating the association of CMR variables to the degree of acute MR, only the extent of MVO was associated (coefficient = 0.27, P = 0.001). The area under the curve for the presence of MVO was 0.66 (P = 0.01) for MR > 2.5 ml. We conclude that in patients with reperfused STEMI, the degree of acute MR is associated with the degree of MVO.

Item Type: Article
Additional Information: Funding: PG and AJS are funded by Wellcome Trust Clinical Research Career Development Fellowships (220703/Z/20/Z & 205188/Z/16/Z). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Rights retention statement: For the purpose of Open Access, these authors have applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission.
Uncontrolled Keywords: st-segment elevation myocardial infarction,magnetic resonance imaging,haemodynamics,mitral regurgitation,mitral regurgitation,biochemistry, genetics and molecular biology(all) ,/dk/atira/pure/subjectarea/asjc/1300
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023)
Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit
Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health
Faculty of Science > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health
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Depositing User: LivePure Connector
Date Deposited: 24 May 2022 14:59
Last Modified: 25 Sep 2024 16:21
URI: https://ueaeprints.uea.ac.uk/id/eprint/85087
DOI: 10.1186/s13104-022-06063-7

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