Abstract：
OBJECTIVE: To evaluate the changes in cardiac magnetic resonance (CMR) characteristics and investigate the predictors of reverse left ventricular remodeling (r-LVR) in ST-segment elevation myocardial infarction (STEMI) patients.
METHODS: Eighty-six STEMI patients (median 56 years) were retrospectively studied. The patients were divided into r-LVR and without r-LVR groups. CMR analysis included LV volume, infarct characteristics, and global and regional myocardial function. The strain and displacement were assessed by CMR-feature tracking. The predictors of r-LVR were analyzed by the logistic regression method.
RESULTS: There were 37 patients in the r-LVR group and 49 patients in the without r-LVR group. At initial CMR, there was no difference in LV volume and global cardiac function between the two groups. However, the infarct zone radial and longitudinal displacements were higher in the r-LVR group (p < 0.05, respectively). At the second CMR, the r-LVR group showed higher LVEF, lower LV volume, and total enhanced mass (all p < 0.05). The infarct zone radial and circumferential strains and radial displacement were higher in the r-LVR group (all p < 0.05). The r-LVR group had better recovery of myocardial injury and function. Of note, microvascular obstruction (MVO) mass (odds ratio: 0.779 (0.613-0.989), p = 0.041) and infarct zone peak longitudinal displacement (PLD) (odds ratio: 1.448 (1.044-2.008), p = 0.026) were independent predictors of r-LVR.
CONCLUSIONS: At initial CMR, there were no differences in global cardiac function between the two groups, but infarct zone displacements were higher in the r-LVR group. The r-LVR group had better recovery of cardiac function. In addition, MVO mass and infarct zone PLD were independent predictors of r-LVR.
CONCLUSIONS: Our study assessed changes in cardiac structure, function, and tissue characteristics after STEMI by CMR, investigated the best predictors of r-LVR in STEMI patients, and laid the foundation for the development of new parameter-guided treatment strategies for STEMI patients.
CONCLUSIONS: • At initial CMR, the reverse left ventricular remodeling (r-LVR) group had less myocardial damage and higher infarct zone displacement, but there were no differences in global function between the two groups. • Both groups showed recovery of myocardial injury and cardiac function over time, but the r-LVR group had less enhanced mass and better cardiac function compared to the without r-LVR group at the second CMR. • Microvascular obstruction mass and infarct zone peak longitudinal displacement by cardiac magnetic resonance feature-tracking were significant predictors of r-LVR in STEMI patients.
METHODS: Eighty-six STEMI patients (median 56 years) were retrospectively studied. The patients were divided into r-LVR and without r-LVR groups. CMR analysis included LV volume, infarct characteristics, and global and regional myocardial function. The strain and displacement were assessed by CMR-feature tracking. The predictors of r-LVR were analyzed by the logistic regression method.
RESULTS: There were 37 patients in the r-LVR group and 49 patients in the without r-LVR group. At initial CMR, there was no difference in LV volume and global cardiac function between the two groups. However, the infarct zone radial and longitudinal displacements were higher in the r-LVR group (p < 0.05, respectively). At the second CMR, the r-LVR group showed higher LVEF, lower LV volume, and total enhanced mass (all p < 0.05). The infarct zone radial and circumferential strains and radial displacement were higher in the r-LVR group (all p < 0.05). The r-LVR group had better recovery of myocardial injury and function. Of note, microvascular obstruction (MVO) mass (odds ratio: 0.779 (0.613-0.989), p = 0.041) and infarct zone peak longitudinal displacement (PLD) (odds ratio: 1.448 (1.044-2.008), p = 0.026) were independent predictors of r-LVR.
CONCLUSIONS: At initial CMR, there were no differences in global cardiac function between the two groups, but infarct zone displacements were higher in the r-LVR group. The r-LVR group had better recovery of cardiac function. In addition, MVO mass and infarct zone PLD were independent predictors of r-LVR.
CONCLUSIONS: Our study assessed changes in cardiac structure, function, and tissue characteristics after STEMI by CMR, investigated the best predictors of r-LVR in STEMI patients, and laid the foundation for the development of new parameter-guided treatment strategies for STEMI patients.
CONCLUSIONS: • At initial CMR, the reverse left ventricular remodeling (r-LVR) group had less myocardial damage and higher infarct zone displacement, but there were no differences in global function between the two groups. • Both groups showed recovery of myocardial injury and cardiac function over time, but the r-LVR group had less enhanced mass and better cardiac function compared to the without r-LVR group at the second CMR. • Microvascular obstruction mass and infarct zone peak longitudinal displacement by cardiac magnetic resonance feature-tracking were significant predictors of r-LVR in STEMI patients.
摘要：
目的：评估ST段抬高型心肌梗死（STEMI）患者心脏磁共振（CMR）特征的变化，探讨左心室重构逆转（r-LVR）的预测因素。
方法：对86例STEMI患者（中位56年）进行回顾性研究。将患者分为r-LVR组和无r-LVR组。CMR分析包括LV体积，梗死特征,以及整体和区域心肌功能。通过CMR特征跟踪评估应变和位移。采用Logistic回归分析r-LVR的预测因子。
结果：r-LVR组37例，无r-LVR组49例。在最初的CMR，两组的LV容量和整体心功能无差异.然而,r-LVR组梗死区径向和纵向位移较高(p<0.05)。在第二次CMR，r-LVR组LVEF较高,低LV音量,和总增强质量(所有p<0.05)。r-LVR组梗死区径向和周向应变及径向位移均较高(均p<0.05)。r-LVR组心肌损伤和功能恢复较好。值得注意的是，微血管阻塞（MVO）质量（比值比：0.779（0.613-0.989），p=0.041）和梗死区峰值纵向位移（PLD）（赔率比：1.448（1.044-2.008），p=0.026)是r-LVR的独立预测因子。
结论：在初始CMR，两组间整体心功能无差异,但r-LVR组梗死区位移较高。r-LVR组心功能恢复较好。此外,MVO质量和梗死区PLD是r-LVR的独立预测因子。
结论：我们的研究评估了心脏结构的变化，函数,通过CMR观察STEMI后的组织特征，调查了STEMI患者r-LVR的最佳预测因子，为STEMI患者新的参数指导治疗策略的开发奠定了基础。
结论：•在初始CMR时，左心室重构逆转(r-LVR)组心肌损伤较轻,梗死区位移较高,但两组间整体功能无差异。•两组均显示心肌损伤和心脏功能随时间恢复，但在第二次CMR时,与无r-LVR组相比,r-LVR组的质量增强较少,心脏功能较好.•通过心脏磁共振特征跟踪的微血管阻塞质量和梗死区峰值纵向位移是STEMI患者r-LVR的重要预测因子。
方法：对86例STEMI患者（中位56年）进行回顾性研究。将患者分为r-LVR组和无r-LVR组。CMR分析包括LV体积，梗死特征,以及整体和区域心肌功能。通过CMR特征跟踪评估应变和位移。采用Logistic回归分析r-LVR的预测因子。
结果：r-LVR组37例，无r-LVR组49例。在最初的CMR，两组的LV容量和整体心功能无差异.然而,r-LVR组梗死区径向和纵向位移较高(p<0.05)。在第二次CMR，r-LVR组LVEF较高,低LV音量,和总增强质量(所有p<0.05)。r-LVR组梗死区径向和周向应变及径向位移均较高(均p<0.05)。r-LVR组心肌损伤和功能恢复较好。值得注意的是，微血管阻塞（MVO）质量（比值比：0.779（0.613-0.989），p=0.041）和梗死区峰值纵向位移（PLD）（赔率比：1.448（1.044-2.008），p=0.026)是r-LVR的独立预测因子。
结论：在初始CMR，两组间整体心功能无差异,但r-LVR组梗死区位移较高。r-LVR组心功能恢复较好。此外,MVO质量和梗死区PLD是r-LVR的独立预测因子。
结论：我们的研究评估了心脏结构的变化，函数,通过CMR观察STEMI后的组织特征，调查了STEMI患者r-LVR的最佳预测因子，为STEMI患者新的参数指导治疗策略的开发奠定了基础。
结论：•在初始CMR时，左心室重构逆转(r-LVR)组心肌损伤较轻,梗死区位移较高,但两组间整体功能无差异。•两组均显示心肌损伤和心脏功能随时间恢复，但在第二次CMR时,与无r-LVR组相比,r-LVR组的质量增强较少,心脏功能较好.•通过心脏磁共振特征跟踪的微血管阻塞质量和梗死区峰值纵向位移是STEMI患者r-LVR的重要预测因子。
