Article Text

PDF

114 Persistence of Haemoglobin Degradation Products within Infarct Scar Tissue after ST-elevation Myocardial Infarction: Incidence, Correlates and Implications for Left Ventricular Remodelling
  1. Jaclyn Carberry1,
  2. David Carrick1,
  3. Caroline Haig2,
  4. Sam Rauhalammi1,
  5. Nadeem Ahmed1,
  6. Ify Mordi1,
  7. Margaret McEntegart1,
  8. Mark Petrie1,
  9. Hany Eteiba1,
  10. Stuart Hood1,
  11. Stuart Watkins1,
  12. Mitchell Lindsay1,
  13. Andrew Davie1,
  14. Ahmed Mahrous1,
  15. Ian Ford2,
  16. Naveed Sattar1,
  17. Paul Welsh1,
  18. Keith G Oldroyd1,
  19. Aleksandra Radjenovic1,
  20. Colin Berry1
  1. 1BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow
  2. 2Robertson Centre for Biostatistics, University of Glasgow

Abstract

Background Myocardial haemorrhage is a prognostically important complication of acute ST-elevation myocardial infarction (STEMI). Persistence of haemoglobin degradation products within infarct scar tissue and the potential clinical significance have not been investigated.

Methods and Results Patients who sustained an acute STEMI were enrolled in a cohort study (BHF MR-MI; ClinicalTrials.gov: NCT02072850). 211 patients (mean (SD) age 57 (11) years, 77% male) had evaluable T2* cardiac magnetic resonance (CMR) imaging (1.5 Tesla) 2 days 6 months post-MI. Myocardial haemorrhage was defined as a hypointense infarct core with T2* signal <20ms. At 2 days, 79 (37%) patients had evidence of myocardial haemorrhage. At 6 months, 47 (59%) patients had a hypointense infarct core and 32 (41%) did not. None of the patients had de novo haemorrhage after the first CMR scan. Clinical associates of a persistent hypointense core at 6 months included hypertension (odds ratio (95% confidence interval) 0.28 (0.08, 0.95); p = 0.040), heart rate (1.08 (1.03, 1.13); p = 0.001), systolic blood pressure (1.06 (1.01, 1.12); p = 0.015), neutrophil count (2.19 (1.01, 4.74); p = 0.048), left anterior descending as culprit artery (9.26 (1.26, 67.99); p = 0.029), infarct size (1.10 (1.03, 1.17); p = 0.004) and initial haemorrhage size (1.34 (1.06, 1.66); p = 0.012). A hypointense infarct core with T2*-mapping at 6 months was associated with worsening LV end-diastolic volume (regression coefficient (95% confidence interval) 15.43 (1.35, 29.50); p = 0.032) and worsening left ventricular ejection fraction (-4.15 (-7.40, -0.89); p = 0.013).

Conclusion Persistence of haemoglobin degradation products at 6 months post-STEMI is common and prognostically important.

  • cardiac magnetic resonance imaging
  • myocardial haemorrhage
  • ST-elevation myocardial infarction

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.