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Impact of coronary artery collaterals on infarct size assessed by serial cardiac magnetic resonance imaging after primary percutaneous coronary intervention in patients with acute myocardial infarction

Authors
 Se-Jung Yoon  ;  Young-Guk Ko  ;  Jung-Sun Kim  ;  Jae-Youn Moon  ;  Young-Jin Kim  ;  Sungha Park  ;  Jong-Won Ha  ;  Donghoon Choi  ;  Yangsoo Jang  ;  Namsik Chung  ;  Won-Heum Shim  ;  Seung-Yun Cho 
Citation
 CORONARY ARTERY DISEASE, Vol.20(7) : 440-445, 2009 
Journal Title
CORONARY ARTERY DISEASE
ISSN
 0954-6928 
Issue Date
2009
MeSH
Aged ; Angioplasty, Balloon, Coronary* ; Anterior Wall Myocardial Infarction/pathology ; Anterior Wall Myocardial Infarction/physiopathology ; Anterior Wall Myocardial Infarction/therapy* ; Collateral Circulation* ; Contrast Media ; Coronary Angiography ; Coronary Circulation* ; Female ; Gadolinium DTPA ; Humans ; Magnetic Resonance Imaging, Cine* ; Male ; Middle Aged ; Myocardium/pathology* ; Prospective Studies ; Stroke Volume ; Time Factors ; Treatment Outcome ; Ventricular Function, Left ; Ventricular Remodeling
Keywords
acute myocardial infarction ; cardiac magnetic resonance ; coronary artery collaterals ; delayed hyperenhancement
Abstract
OBJECTIVES: Coronary collaterals have been shown to protect ischemic myocardium from necrosis in patients with acute myocardial infarction (AMI). We sought to determine the impact of collateral circulation on infarct size in AMI using serial cardiac magnetic resonance (CMR).

METHODS: A total of 46 anterior AMI patients (age, 58.9+/-10.6 years; male 72.3%) undergoing primary percutaneous coronary intervention (PCI) were investigated. The infarct size was measured on serial CMR performed within 7 days after primary PCI (acute stage) and 3 months later (chronic stage).

RESULTS: Thirty-four patients (73.9%) showed collateral flow before primary PCI. CMR taken at the acute stage showed no significant difference in infarct size between two groups. However, follow-up CMR revealed significantly smaller percentage of infarct thickness (51.8+/-14.0 vs. 62.5+/-11.7%, P = 0.035) and mass (22.3+/-9.9 vs. 30.9+/-11.6%, P = 0.042) in patients with collaterals. There were significant changes from the acute to chronic stage regarding left ventricular end-systolic (-18.2+/-10.0 vs. 0.8+/-2.5 ml, P = 0.022) and end-diastolic volume (-14.8+/-9.2 vs. 2.6+/-13.7 ml, P = 0.031), percentage of infarct mass (-6.1+/-2.8 vs. -0.8+/-1.1%, P = 0.034), and thickness (-8.9+/-3.3 vs. -3.1+/-2.8%, P = 0.029) in collateral group compared with noncollateral group on serial CMR.

CONCLUSION: Serial CMR revealed the effect of collaterals in patients with AMI on reduction of infarct size and improvement of myocardial remodeling at the chronic stage.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00019501-200911000-00003&LSLINK=80&D=ovft
DOI
10.1097/MCA.0b013e328330c930
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Shim, Won Heum(심원흠)
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Chung, Nam Sik(정남식)
Cho, Seung Yun(조승연)
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/105744
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