並列タイトル等再灌流後急性心筋梗塞患者におけるリバースリモデリングと非造影T1低信号梗塞コア
一般注記type:Thesis
Background: Non-contrast T1 hypointense infarct cores (ICs) within infarcted myocardium detected using cardiac magnetic resonance
imaging (CMR) T1 mapping may help assess the severity of left ventricular (LV) injury. However, because the relationship of
ICs with chronic LV reverse remodeling (LVRR) is unknown, this study aimed to clarify it.
Methods and Results: We enrolled patients with reperfused AMI who underwent baseline CMR on day-7 post-primary percutaneous
coronary intervention (n=109) and 12-month follow-up CMR (n=94). Correlations between ICs and chronic LVRR (end-systolic
volume decrease ≥15% at 12-month follow-up from baseline CMR) were investigated. We detected 52 (47.7%) ICs on baseline CMR
by non-contrast-T1 mapping. LVRR was found in 52.1% of patients with reperfused AMI at 12-month follow-up. Patients with ICs
demonstrated higher peak creatine kinase levels, higher B-type natriuretic peptide levels at discharge, lower LV ejection fraction at
discharge, and lower incidence of LVRR than those without ICs (26.5% vs. 73.3%, P<0.001) at follow-up. Multivariate logistic regression
analysis showed that the presence of ICs was an independent and the strongest negative predictor for LVRR at 12-month followup
(hazard ratio: 0.087, 95% confidence interval: 0.017–0.459, P=0.004). Peak creatine kinase levels, native T1 values at myocardial
edema, and myocardial salvaged indices also correlated with ICs.
Conclusions: ICs detected by non-contrast-T1 mapping with 3.0-T CMR were an independent negative predictor of LVRR in patients
with reperfused AMI.
博士(医学)・乙第1529号・令和5年3月15日
© 2022, THE JAPANESE CIRCULATION SOCIETY
This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.
identifier:Circulation journal Vol.86 No.12 p.1968-1979 (2022 Nov)
identifier:13469843
identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/4114
identifier:Circulation journal, 86(12): 1968-1979
連携機関・データベース国立情報学研究所 : 学術機関リポジトリデータベース(IRDB)(機関リポジトリ)
提供元機関・データベース奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU