Anne Bethke has evaluated what myocardial perfusion recorded with angiography and cardiac MRI can tell us about long-term cardiac function after successful PCI treatment.

MAIN RESULTS:

1. Myocardial perfusion recorded on angiography associates with infarct size and left ventricular function four months after PCI.
2. Perfusion imaging with cardiac MRI predicts reduced cardiac function following STEMI.
3. Patients with low myocardial perfusion a few days after PCI still have reduced perfusion four months later.

THESIS DEFENCE:

Thesis: Microvascular perfusion in STEMI patients in infarcted and remote myocardium: Angiographic and CMR findings
Candidate: Anne Bethke
Time: March 22 at 13:15
Place: Oslo University Hospital, Ullevål, Kreftsenteret: Auditorium 1
Link to university website

SUMMARY:

(1) Reduced myocardial perfusion shown on angiography immediately after PCI predicts reduced left ventricular ejection fraction and increased infarct size in patients with ST-elevation myocardial infarction. Also CMR first-pass perfusion imaging performed a few days after PCI is associated with reduced left ventricular function at follow-up.

Bethke recorded myocardial perfusion with angiography and CMR in 198 STEMI patients. The cardiac outcomes were measured four months later by cardiac magnetic resonance imaging. CMR first-pass perfusion improved after four months, but was still reduced in the patients with the lowest initial perfusion.

(2) Myocardial perfusion recorded with CMR a few days after treatment for STEMI is lower in the infarcted area compared to the area of the ventricle that is not directly affected. The difference diminishes over time. Patients with low perfusion have lower ejection fraction, larger infarct size and area at risk, smaller myocardial salvage and higher occurence of microvascular obstrauction.

REFERENCES:

(1) Bethke, A., Shanmuganathan, L., Andersen, G. Ø., Eritsland, J., Swanson, D., Kløw, N. E., & Hoffmann, P. (2019). Microvascular perfusion in infarcted and remote myocardium after successful primary PCI: angiographic and CMR findings. European radiology, 29(2), 941-950.

(2) Bethke, A., Shanmuganathan, L., Shetelig, C., Swanson, D., Andersen, G. Ø., Eritsland, J., Kløw, N. E., & Hoffmann, P. (2018). MR findings of microvascular perfusion in infarcted and remote myocardium early after successful primary PCI. PloS one, 13(11), e0206723.