Journal of Shanghai Jiao Tong University (Medical Science) >

2021 , Vol. 41 >Issue 2: 173 - 179

DOI: https://doi.org/10.3969/j.issn.1674-8115.2021.02.008

Clinical research

Effect of microvascular obstruction on left ventricle function and prognosis in patients with ST-segment elevation myocardial infarction

  • Pei-kun HU ,
  • Jie HE ,
  • Lian-ming WU ,
  • Heng GE ,
  • Jian-rong XU ,
  • Jun PU
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  • Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China

Received date: 2020-06-01

  Online published: 2021-02-28

Supported by

National Science Fund for Distinguished Young Scholars(81625002);Shanghai Outstanding Academic Leaders Program(18XD1402400);Innovative Research Team of High-Level Local Universities in Shanghai(SSMU-ZDCX20180200);Clinical Research Plan of Shanghai Hospital Development Center(16CR3034A);Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support(20152209)

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Abstract

Objective

·To investigate the effect of microvascular obstruction (MVO) on left ventricle function and prognosis in patients with ST-segment elevation myocardial infarction (STEMI) by using cardiac magnetic resonance (CMR) technique.

Methods

·A total of 124 patients with STEMI in the Department of Cardiology of Renji Hospital, Shanghai Jiao Tong University School of Medicine from January 2016 to December 2017 were enrolled. The percentage of myocardial infarction size, the percentage of myocardial MVO size and left ventricle function after reperfusion were evaluated by CMR technique. According to the percentage of myocardial MVO size, the patients were divided into MVO (+) group and MVO (-) group. The baseline characteristics, blood biochemical indexes and CMR indexes of the two groups were compared. The MVO (+) group was further divided into 4 subgroups according to the quartiles of the percentage of myocardial infarction size. Pearson correlation analysis was used to explore the correlation between the percentage of myocardial MVO size and left ventricular ejection fractions (LVEF) in each subgroup. The incidence of adverse events within 30 days was observed. Receiver operating characteristic curve (ROC curve) was used to analyze the predictive value of the percentage of myocardial MVO size for adverse events.

Results

·The white blood cell count, creatine phosphokinase, creatine kinase MB, cardiac troponin I and total cholesterol in the MVO (+) group were significantly higher than those in the MVO (-) group (all P<0.05), while baseline characteristics showed no significant difference. LVEF in the MVO (+) group was lower than that in the MVO (-) group (P=0.000). Pearson correlation analysis showed that the percentage of myocardial MVO size was negatively correlated with LVEF (all P<0.05). ROC curve showed that the area under the curve of the percentage of myocardial MVO size in the prediction of adverse events within 30 days was 0.889 (95%CI 0.823?0.975), and the sensitivity and specificity of the percentage of myocardial MVO size were more higher than that of the percentage of myocardial infarction size.

Conclusion

·The left ventricle function and prognosis in STEMI patients with MVO are worse, suggesting that more attention should be paid to the clinical intervention for such patients.

Key words： cardiac magnetic resonance (CMR); ST-segment elevation myocardial infarction (STEMI); microvascular obstruction (MVO); left ventricle function; prognosis

Cite this article

Pei-kun HU , Jie HE , Lian-ming WU , Heng GE , Jian-rong XU , Jun PU . Effect of microvascular obstruction on left ventricle function and prognosis in patients with ST-segment elevation myocardial infarction[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2021 , 41(2) : 173 -179 . DOI: 10.3969/j.issn.1674-8115.2021.02.008

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