TY - JOUR
T1 - Peak CK-MB has a strong association with chronic scar size and wall motion abnormalities after revascularized non-transmural myocardial infarction-A prospective CMR study
AU - Pöyhönen, Pauli
AU - Kylmälä, Minna
AU - Vesterinen, Paula
AU - Kivistö, Sari
AU - Holmström, Miia
AU - Lauerma, Kirsi
AU - Väänänen, Heikki
AU - Toivonen, Lauri
AU - Hänninen, Helena
PY - 2018/2/8
Y1 - 2018/2/8
N2 - Background: Large myocardial infarction (MI) is associated with adverse left ventricular (LV) remodeling (LVR). We studied the nature of LVR, with specific attention to non-transmural MIs, and the association of peak CK-MB with recovery and chronic phase scar size and LVR. Methods: Altogether 41 patients underwent prospectively repeated cardiovascular magnetic resonance at a median of 22 (interquartile range 9-29) days and 10 (8-16) months after the first revascularized MI. Transmural MI was defined as ≥75% enhancement in at least one myocardial segment. Results: Peak CK-MB was 86 (40-216) μg/L in median, while recovery and chronic phase scar size were 13 (3-23) % and 8 (2-19) %. Altogether 33 patients (81%) had a non-transmural MI. Peak CK-MB had a strong correlation with recovery and chronic scar size (r≥0.80 for all, r≥0.74 for non-transmural MIs; p<0.001). Peak CK-MB, recovery scar size, and chronic scar size, were all strongly correlated with chronic wall motion abnormality index (WMAi) (r≥0.75 for all, r≥0.73 for non-transmural MIs; p<0.001). There was proportional scar size and LV mass resorption of 26% (0-50%) and 6% (-2-14%) in median. Young age (<60 years, median) was associated with greater LV mass resorption (median 9%vs.1%, p=0.007). Conclusions: Peak CK-MB has a strong association with chronic scar size and wall motion abnormalities after revascularized non-transmural MI. Considerable infarct resorption happens after the first-month recovery phase. LV mass resorption is related to age, being more common in younger patients.
AB - Background: Large myocardial infarction (MI) is associated with adverse left ventricular (LV) remodeling (LVR). We studied the nature of LVR, with specific attention to non-transmural MIs, and the association of peak CK-MB with recovery and chronic phase scar size and LVR. Methods: Altogether 41 patients underwent prospectively repeated cardiovascular magnetic resonance at a median of 22 (interquartile range 9-29) days and 10 (8-16) months after the first revascularized MI. Transmural MI was defined as ≥75% enhancement in at least one myocardial segment. Results: Peak CK-MB was 86 (40-216) μg/L in median, while recovery and chronic phase scar size were 13 (3-23) % and 8 (2-19) %. Altogether 33 patients (81%) had a non-transmural MI. Peak CK-MB had a strong correlation with recovery and chronic scar size (r≥0.80 for all, r≥0.74 for non-transmural MIs; p<0.001). Peak CK-MB, recovery scar size, and chronic scar size, were all strongly correlated with chronic wall motion abnormality index (WMAi) (r≥0.75 for all, r≥0.73 for non-transmural MIs; p<0.001). There was proportional scar size and LV mass resorption of 26% (0-50%) and 6% (-2-14%) in median. Young age (<60 years, median) was associated with greater LV mass resorption (median 9%vs.1%, p=0.007). Conclusions: Peak CK-MB has a strong association with chronic scar size and wall motion abnormalities after revascularized non-transmural MI. Considerable infarct resorption happens after the first-month recovery phase. LV mass resorption is related to age, being more common in younger patients.
KW - Acute myocardial infarction
KW - Cardiovascular magnetic resonance
KW - Coronary artery disease
KW - Creatine kinase-MB
KW - Infarct transmurality
KW - Left ventricular remodeling
UR - http://www.scopus.com/inward/record.url?scp=85041823860&partnerID=8YFLogxK
U2 - 10.1186/s12872-018-0767-7
DO - 10.1186/s12872-018-0767-7
M3 - Article
C2 - 29422025
AN - SCOPUS:85041823860
VL - 18
JO - BMC Cardiovascular Disorders
JF - BMC Cardiovascular Disorders
SN - 1471-2261
IS - 1
M1 - 27
ER -