Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

The Transmural Extent and Severity of Myocardial Hypoperfusion Predicts Long-Term Outcome in NSTEMI: An MDCT Study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Transcatheter Aortic Valve Replacement: Role of Multimodality Imaging in Common and Complex Clinical Scenarios

    Publikation: Bidrag til tidsskriftReviewForskningpeer review

  2. Impact of Multiple Myocardial Scars Detected by CMR in Patients Following STEMI

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. The Authors' Reply

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Cardiovascular complications in patients with total cavopulmonary connection: A nationwide cohort study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Favorable five-year outcomes for heart failure diagnosed in younger patients without severe comorbidity

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Quality of life and the associated risk of all-cause mortality in nonischemic heart failure

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. One-year outcomes in atrial fibrillation presenting during infections: a nationwide registry-based study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

OBJECTIVES: The objective of this study was to test the hypothesis that the extent and severity of left ventricular myocardial hypoperfusion at rest, in addition to signs of left ventricular myocardial scar, are related to adverse long-term outcome in patients with non-ST-segment elevation myocardial infarction (NSTEMI).

BACKGROUND: Multidetector computed tomography (MDCT) is a noninvasive test with a spatial resolution that allows for the assessment of transmural myocardial perfusion. In patients with suspected NSTEMI, the assessment of myocardial hypoperfusion could be clinically useful.

METHODS: MDCT was performed at rest before invasive treatment in 396 patients with NSTEMI. The transmural involvement of left ventricular hypoperfusion, the presence of intramyocardial fat or calcification, a summed defect score adding the extent of left ventricular myocardial hypoperfusion (0 to 64 point scale), and the transmural attenuation ratio between the subendocardial and the subepicardial myocardium were assessed. The study endpoint was a combination of death and hospitalization due to heart failure.

RESULTS: The median follow-up time of the study was 50 months, and the study endpoint was reached in 56 (15%) of the patients. In a Cox proportional hazards survival model with adjustments for known risk factors, both the summed defect score and transmural attenuation ratio were independently associated with adverse outcome (hazard ratio [HR]: 1.07; 95% confidence interval [CI]: 1.02 to 1.11; p = 0.004 and HR: 0.61; 95% CI: 0.44 to 0.85; p = 0.003, respectively). The presence of intramyocardial fat or calcification was also associated with adverse outcome (HR: 3.5; 95% CI: 1.2 to 10.7; p = 0.03) when compared with patients without any perfusion defect.

CONCLUSIONS: The extent and severity of left ventricular myocardial hypoperfusion at rest and signs of left ventricular myocardial scar assessed with MDCT before invasive treatment is strongly linked to adverse long-term outcome in patients with NSTEMI.

OriginalsprogEngelsk
TidsskriftJACC. Cardiovascular imaging
Vol/bind8
Udgave nummer6
Sider (fra-til)684-94
Antal sider11
ISSN1936-878X
DOI
StatusUdgivet - jun. 2015

ID: 46012355