Background: The incidence and clinical significance of persistent T2 hyperintensity after acute ST-segment-elevation myocardial infarction (STEMI) is uncertain.
Methods And Results: Patients who sustained an acute STEMI were enrolled in a cohort study (BHF MR-MI: NCT02072850). Two hundred eighty-three STEMI patients (mean age, 59±12 years; 75% male) had cardiac magnetic resonance with T2 mapping performed at 2 days and 6 months post-STEMI. Persisting T2 hyperintensity was defined as infarct T2 >2 SDs from remote T2 at 6 months. Infarct zone T2 was higher than remote zone T2 at 2 days (66.3±6.1 versus 49.7±2.1 ms; <0.001) and 6 months (56.8±4.5 versus 49.7±2.3 ms; <0.001). Remote zone T2 did not change over time (mean change, 0.0±2.7 ms; =0.837), whereas infarct zone T2 decreased (-9.5±6.4 ms; <0.001). At 6 months, T2 hyperintensity persisted in 189 (67%) patients, who were more likely to have Thrombus in Myocardial Infarction flow 0 or 1 in the culprit artery (=0.020), incomplete ST-segment resolution (=0.037), and higher troponin (=0.024). Persistent T2 hyperintensity was associated with NT-proBNP (N-terminal pro-B-type natriuretic peptide) concentration (0.57 on a log scale [0.42-0.72]; =0.004) and the likelihood of adverse left ventricular remodeling (>20% change in left ventricular end-diastolic volume; 21.91 [2.75-174.29]; =0.004). Persistent T2 hyperintensity was associated with all-cause death and heart failure, but the result was not significant (=0.051). ΔT2 was associated with all-cause death and heart failure (=0.004) and major adverse cardiac events (=0.013).
Conclusions: Persistent T2 hyperintensity occurs in two thirds of STEMI patients. Persistent T2 hyperintensity was associated with the initial STEMI severity, adverse remodeling, and long-term health outcome.
Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02072850.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5753833 | PMC |
| http://dx.doi.org/10.1161/CIRCIMAGING.117.006586 | DOI Listing |
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