Cardiac magnetic resonance imaging features prognostic information in patients with suspected myocardial infarction with non-obstructed coronary arteries.
| Title: | Cardiac magnetic resonance imaging features prognostic information in patients with suspected myocardial infarction with non-obstructed coronary arteries. |
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| Authors: | Emrich T; Department of Diagnostic and Interventional Radiology, University Medical Center, Mainz; Langenbeckst. 1, 55131 Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main, Mainz, Langenbeckst. 1, 55131 Mainz, Germany; Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, 29425, SC, USA.; Kros M; Department of Diagnostic and Interventional Radiology, University Medical Center, Mainz; Langenbeckst. 1, 55131 Mainz, Germany.; Schoepf UJ; Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, 29425, SC, USA. Electronic address: schoepf@musc.edu.; Geyer M; Center for Cardiology, Cardiology I, University Medical Center Mainz, Langenbeckst. 1, 55131 Mainz, Germany.; Mildenberger P; Department of Medical Biometry, Epidemiology and Informatics, University Medical Center Mainz, Langenbeckst. 1, 55131 Mainz, Germany.; Kloeckner R; Department of Diagnostic and Interventional Radiology, University Medical Center, Mainz; Langenbeckst. 1, 55131 Mainz, Germany.; Wenzel P; German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main, Mainz, Langenbeckst. 1, 55131 Mainz, Germany; Center for Cardiology, Cardiology I, University Medical Center Mainz, Langenbeckst. 1, 55131 Mainz, Germany.; Varga-Szemes A; Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, 29425, SC, USA.; Düber C; Department of Diagnostic and Interventional Radiology, University Medical Center, Mainz; Langenbeckst. 1, 55131 Mainz, Germany.; Münzel T; German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main, Mainz, Langenbeckst. 1, 55131 Mainz, Germany; Center for Cardiology, Cardiology I, University Medical Center Mainz, Langenbeckst. 1, 55131 Mainz, Germany.; Kreitner KF; Department of Diagnostic and Interventional Radiology, University Medical Center, Mainz; Langenbeckst. 1, 55131 Mainz, Germany. |
| Source: | International journal of cardiology [Int J Cardiol] 2021 Mar 15; Vol. 327, pp. 223-230. Date of Electronic Publication: 2020 Dec 10. |
| Publication Type: | Journal Article; Observational Study |
| Language: | English |
| Journal Info: | Publisher: Elsevier Country of Publication: Netherlands NLM ID: 8200291 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1874-1754 (Electronic) Linking ISSN: 01675273 NLM ISO Abbreviation: Int J Cardiol Subsets: MEDLINE |
| Imprint Name(s): | Publication: Amsterdam : Elsevier; Original Publication: Amsterdam : Elsevier/North-Holland Biomedical Press, c1981- |
| MeSH Terms: | Myocardial Infarction*/diagnostic imaging ; Coronary Vessels*; Contrast Media ; Coronary Angiography ; Gadolinium ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Imaging, Cine ; Male ; Predictive Value of Tests ; Prognosis ; Retrospective Studies |
| Abstract: | Background: To assess the prognostic implications of cardiac magnetic resonance imaging (CMR) in patients with clinical suspicion of myocardial infarction with non-obstructed coronary arteries (MINOCA).; Methods: A total of 145 patients (58 ± 15 years, 97 men) were retrospectively enrolled in this single-center, longitudinal observational study. All patients underwent CMR including cine, edema-sensitive, and late gadolinium enhancement acquisitions, within a median of 3 days after cardiac catheterization. Follow-up was performed by medical records chart review and phone interviews; the median follow-up time was 4.2 years. The primary endpoint was defined as a combination of death, stroke, new onset of congestive heart failure, recurrent hospitalization, or the need for an invasive cardiac procedure.; Results: In 143 (98.6%) cases, CMR revealed the following cardiac pathologies: myocarditis (n = 48, 33.1%), structural cardiomyopathies (n = 40, 27.6%), "true" myocardial infarction (n = 22, 15.1%), hypertensive heart disease (n = 19, 13.1%), and Tako-Tsubo cardiomyopathy (n = 14, 9.7%). Only two patients (1.4%) had a normal CMR examination. There were significant prognostic differences between different etiologies, e.g. myocarditis and Tako-Tsubo cardiomyopathy had a more favorable prognosis then structural cardiomyopathies. Age, end-diastolic volume index and time-to-CMR showed significant association with the primary endpoint in multi-variate Cox regression.; Conclusions: CMR performed early after the onset of clinical symptoms allows discrimination between acute myocardial injury from "true" MINOCA in patients presenting with chest pain and elevated cardiac biomarkers, thereby helping to identify the underlying pathology in suspected MINOCA and allowing risk stratification based on the established diagnosis. Furthermore, CMR parameters allow for improved prediction of adverse events compared to clinical and laboratory parameters.; (Copyright © 2020. Published by Elsevier B.V.) |
| Competing Interests: | Declaration of Competing Interest TE has received a speaker fee and travel support from Siemens Healthineers, AVS receives institutional research support and travel support from Siemens Healthineers and is consultant for Bayer and Elucid Bioimaging. UJS has received institutional research support and/or honoraria for speaking and consulting from Astellas, Bayer, Bracco, Elucid BioImaging, General Electric, Guerbet, HeartFlow Inc., and Siemens Healthineers. None of these companies supported this studies and none of the authors reports a conflict of interest. |
| Contributed Indexing: | Keywords: Acute coronary syndrome; Cardiac magnetic resonance imaging; Troponin elevation; Unobstructed coronary arteries |
| Substance Nomenclature: | 0 (Contrast Media); AU0V1LM3JT (Gadolinium) |
| Entry Date(s): | Date Created: 20201214 Date Completed: 20210528 Latest Revision: 20210528 |
| Update Code: | 20260130 |
| DOI: | 10.1016/j.ijcard.2020.12.009 |
| PMID: | 33309758 |
| Database: | MEDLINE |
Journal Article; Observational Study