Prognostic Value of a Comprehensive Cardiac Magnetic Resonance Assessment Soon After a First ST-Segment Elevation Myocardial Infarction
Vicente Bodi, MD*,*,
Juan Sanchis, MD*,
Julio Nunez, MD*,
Luis Mainar, MD*,
Maria P. Lopez-Lereu, MD ,
Jose V. Monmeneu, MD,
Eva Rumiz, MD*,
Fabian Chaustre*,
Isabel Trapero*,
Oliver Husser, MD*,
Maria J. Forteza*,
Francisco J. Chorro, MD*,
Angel Llacer, MD*
* Cardiology Department, Hospital Clinico Universitario, Universidad de Valencia, Valencia, Spain
Cardiovascular Magnetic Resonance Imaging Unit, ERESA, Valencia, Spain
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Figure 1 Cardiac Magnetic Resonance Indexes Analyzed
Example of a patient with a large anterior myocardial infarction. (Left) Abnormal wall motion at rest in the apical area (arrow). (Middle) Significant improvement with low-dose dobutamine (arrow) in the same area. (Right) Microvascular obstruction in the core of a large area of necrosis in the mid ventricular area (arrow). WMA = wall motion abnormalities.
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Figure 2 CMR Indexes and MACE Rate
Kaplan-Meier survival distributions without major adverse cardiac events (MACE) on the basis of the presence or absence of abnormal cardiac magnetic resonance (CMR) indexes soon after infarction. WMA = wall motion abnormalities; WMA-dobutamine = WMA with low-dose dobutamine.
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Figure 3 MACE Rate According to the Extents of WMA and Transmural Necrosis
When both WMA at rest and transmural necrosis were absent, the MACE rate was very low; it was intermediate when only 1 index was abnormal and high when both indexes were altered. Abbreviations as in Figure 2.
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