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Myonecrosis following stent placement: Association between impaired TIMI myocardial perfusion grade and MRI visualization of microinfarction

Myonecrosis following stent placement: Association between impaired TIMI myocardial perfusion... Contrast‐enhanced cardiac MRI (ceMRI) and TIMI myocardial perfusion grade analysis (TMPG) are proven methods for visualization of microinfarction and assessment of microvascular perfusion, respectively. To determine whether microvascular obstruction accounts for procedure‐related myonecrosis, 14 poststent patients, 9 with procedural CK‐MB elevation and 5 controls, underwent ceMRI and TMPG. All had TIMI 3 flow pre‐ and poststent. TMPG was normal in 12/14 pre‐ and 7/14 poststent. Those with poststent decline in TMPG had higher CK‐MB (median, 41.0 vs. 7.4 ng/mL; P = 0.01) and larger infarct mass (median, 3.1 vs. 0.89 g; P = 0.04). More extensive myonecrosis (CK‐MB > 3 × normal; infarct mass > 3 g) was observed more frequently if there was a poststent decline in TMPG (3/3, 100%, vs. 2/11, 18.2%; P = 0.03). These data support the theory that distal embolization and microvascular obstruction are associated with myonecrosis following otherwise successful coronary stent placement and provide further insight into its pathophysiology. Catheter Cardiovasc Interv 2004;61:472–476. © 2004 Wiley‐Liss, Inc. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Catheterization and Cardiovascular Interventions Wiley

Myonecrosis following stent placement: Association between impaired TIMI myocardial perfusion grade and MRI visualization of microinfarction

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References (37)

Publisher
Wiley
Copyright
Copyright © 2004 Wiley‐Liss, Inc.
ISSN
1522-1946
eISSN
1522-726X
DOI
10.1002/ccd.20024
pmid
15065140
Publisher site
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Abstract

Contrast‐enhanced cardiac MRI (ceMRI) and TIMI myocardial perfusion grade analysis (TMPG) are proven methods for visualization of microinfarction and assessment of microvascular perfusion, respectively. To determine whether microvascular obstruction accounts for procedure‐related myonecrosis, 14 poststent patients, 9 with procedural CK‐MB elevation and 5 controls, underwent ceMRI and TMPG. All had TIMI 3 flow pre‐ and poststent. TMPG was normal in 12/14 pre‐ and 7/14 poststent. Those with poststent decline in TMPG had higher CK‐MB (median, 41.0 vs. 7.4 ng/mL; P = 0.01) and larger infarct mass (median, 3.1 vs. 0.89 g; P = 0.04). More extensive myonecrosis (CK‐MB > 3 × normal; infarct mass > 3 g) was observed more frequently if there was a poststent decline in TMPG (3/3, 100%, vs. 2/11, 18.2%; P = 0.03). These data support the theory that distal embolization and microvascular obstruction are associated with myonecrosis following otherwise successful coronary stent placement and provide further insight into its pathophysiology. Catheter Cardiovasc Interv 2004;61:472–476. © 2004 Wiley‐Liss, Inc.

Journal

Catheterization and Cardiovascular Interventions – Wiley

Published: Apr 1, 2004

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