Two left ventricular pseudoaneurysms complicating a myocardial infarction. The impact of cardiac magnetic resonance in the acute setting.

2021 ◽  
Author(s):  
Alvise Del Monte ◽  
Martina Perazzolo Marra ◽  
Francesco Cardaioli ◽  
Gino Gerosa ◽  
Sabino Iliceto ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Left Ventricular ◽  
Acute Setting ◽  
The Impact

scholarly journals Cardiac magnetic resonance derived global longitudinal strain outperfoms established functional parameters in prognostication after ST-elevation myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Holzknecht ◽  
M Reindl ◽  
C Tiller ◽  
I Lechner ◽  
T Hornung ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Prognostic Value ◽  
Longitudinal Strain ◽  
Independent Predictor ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Lv Function ◽  
St Elevation

Abstract Background Left ventricular ejection fraction (LVEF) is the parameter of choice for left ventricular (LV) function assessment and risk stratification of patients with ST-elevation myocardial infarction (STEMI); however, its prognostic value is limited. Other measures of LV function such as global longitudinal strain (GLS) and mitral annular plane systolic excursion (MAPSE) might provide additional prognostic information post-STEMI. However, comprehensive investigations comparing these parameters in terms of prediction of hard clinical events following STEMI are lacking so far. Purpose We aimed to investigate the comparative prognostic value of LVEF, MAPSE and GLS by cardiac magnetic resonance (CMR) imaging in the acute stage post-STEMI for the occurrence of major adverse cardiac events (MACE). Methods This observational study included 407 consecutive acute STEMI patients treated with primary percutaneous coronary intervention (PCI). Comprehensive CMR investigations were performed 3 [interquartile range (IQR): 2–4] days after PCI to determine LVEF, GLS and MAPSE as well as myocardial infarct characteristics. Primary endpoint was the occurrence of MACE defined as composite of death, re-infarction and congestive heart failure. Results During a follow-up of 21 [IQR: 12–50] months, 40 (10%) patients experienced MACE. LVEF (p=0.005), MAPSE (p=0.001) and GLS (p<0.001) were significantly related to MACE. GLS showed the highest prognostic value with an area under the curve (AUC) of 0.71 (95% CI 0.63–0.79; p<0.001) compared to MAPSE (AUC: 0.67, 95% CI 0.58–0.75; p=0.001) and LVEF (AUC: 0.64, 95% CI 0.54–0.73; p=0.005). After multivariable analysis, GLS emerged as sole independent predictor of MACE (HR: 1.22, 95% CI 1.11–1.35; p<0.001). Of note, GLS remained associated with MACE (p<0.001) even after adjustment for infarct size and microvascular obstruction. Conclusion CMR-derived GLS emerged as strong and independent predictor of MACE after acute STEMI with additive prognostic validity to LVEF and parameters of myocardial damage. Funding Acknowledgement Type of funding source: None

Abstract 9634: As Compared With Cardiac Magnetic Resonance Imaging, Transthoracic Echocardiography Has an Excellent Accuracy in Diagnosing a Left Ventricular Thrombus After an Anterior Myocardial Infarction Complicated With Left Ventricular Dysfunction: Results of a Prospective Multicentric Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Philippe Meurin ◽  
Virginie Brandao Carreira ◽  
Raphaelle D Dumaine ◽  
Alain Shqueir ◽  
Olivier Milleron ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Cardiac Magnetic Resonance Imaging ◽  
Antiplatelet Therapy ◽  
Transthoracic Echocardiography ◽  
Dual Antiplatelet Therapy ◽  
Left Ventricular ◽  
Resonance Imaging

Introduction: The generalization of reperfusion techniques to treat acute myocardial infarction (MI) has allowed for markedly reduced incidence in left ventricular (LV) thrombi because of the reduced myocardial damage. LV thrombi are estimated to complicate 5% to 10% of unselected anterior-wall MI (Ant-MI). However, the incidence and evolution of LV thrombi in high-risk patients with Ant-MI complicated by LV systolic dysfunction is not well known. Cardiac magnetic resonance imaging with contrast delayed enhancement (CMR-DE) is the gold standard in assessing LV thrombus, but comparisons of transthoracic echocardiography (TTE) and CMR-DE are scarce. Hypothesis: We assessed whether LV thrombi are still frequent after major Ant-MI, despite systematic dual antiplatelet therapy, and whether focused TTE has a good accuracy for detection as compared with CMR-DE. Methods: From 2011 to 2013, from 7 centers, we prospectively included patients with LV ejection fraction (LVEF) < 45% at a first TTE performed < 7 days after Ant-MI. A second evaluation including TTE and CMR-DE (analyzed by blinded examiners) was performed at 30 days. A third TTE and assessment of clinical status and adverse events were performed between months 6 and 12. Results: We included 100 consecutive patients (71% males; mean age 59.1 ± 12.1 years; LVEF 33.5 ± 6.0%) at a mean of 4.8 ± 1.9 days after Ant-MI; 88% had undergone primary coronary angioplasty. In total, 26 patients had LV thrombi detected at a mean of 23.2 ± 34.8 days after MI (6 during the first week after the MI, 16 from days 8 to 30, 4 after day 30). As compared with CMR-DE, TTE sensitivity and specificity were 94.7% and 98.5%, respectively. For 24 patients (92.3%), the LV thrombi disappeared with triple antithrombotic therapy including dual antiplatelet therapy and a vitamin K antagonist. One patient died from a recurrent subdural haematoma and another had a peripheral embolism. Conclusions: In this prospective multicenter study, LV thrombus occurred in 26% of patients after Ant-MI complicated by LV dysfunction. Focused TTE has a high accuracy for detection. CMR-DE should be performed only when the apex is not clearly seen.

Cardiac magnetic resonance detection of left ventricular thrombus in acute myocardial infarction

2013 ◽  
Vol 15 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Chiara Lanzillo ◽  
Mauro Di Roma ◽  
Alessandro Sciahbasi ◽  
Monia Minati ◽  
Luciano Maresca ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Ventricular Thrombus ◽  
Resonance Detection
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