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Left ventricular functional recovery of infarcted and remote myocardium after ST-segment elevation myocardial infarction (METOCARD-CNIC randomized clinical trial substudy)

Journal of cardiovascular magnetic resonance, 2020-06, Vol.22 (1), p.44-12, Article 44 [Peer Reviewed Journal]

COPYRIGHT 2020 BioMed Central Ltd. ;COPYRIGHT 2020 BioMed Central Ltd. ;2020. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;The Author(s) 2020 ;ISSN: 1532-429X ;ISSN: 1097-6647 ;EISSN: 1532-429X ;DOI: 10.1186/s12968-020-00638-8 ;PMID: 32522198

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Title:
Left ventricular functional recovery of infarcted and remote myocardium after ST-segment elevation myocardial infarction (METOCARD-CNIC randomized clinical trial substudy)
Author: Podlesnikar, Tomaž ; Pizarro, Gonzalo ; Fernández-Jiménez, Rodrigo ; Montero-Cabezas, Jose M ; Greif, Nina ; Sánchez-González, Javier ; Bucciarelli-Ducci, Chiara ; Marsan, Nina Ajmone ; Fras, Zlatko ; Bax, Jeroen J ; Fuster, Valentin ; Ibáñez, Borja ; Delgado, Victoria
Subjects: Administration, Intravenous ; Adrenergic beta-1 Receptor Antagonists - administration & dosage ; Adrenergic beta-1 Receptor Antagonists - adverse effects ; Aged ; Anterior Wall Myocardial Infarction - diagnostic imaging ; Anterior Wall Myocardial Infarction - pathology ; Anterior Wall Myocardial Infarction - physiopathology ; Anterior Wall Myocardial Infarction - therapy ; Automation ; Balloon angioplasty ; Circumferences ; Clinical trials ; Complications ; Coronary vessels ; Demographics ; Edema ; Evaluation ; Feature-tracking cardiovascular magnetic resonance ; Female ; Heart ; Heart attack ; Heart attacks ; Hemorrhage ; Humans ; Intramyocardial hemorrhage ; Intravenous administration ; Intravenous metoprolol ; Left ventricular remodeling ; Magnetic resonance ; Magnetic Resonance Imaging, Cine ; Male ; Metoprolol ; Metoprolol - administration & dosage ; Metoprolol - adverse effects ; Microvascular obstruction ; Microvasculature ; Middle Aged ; Myocardial infarction ; Myocardium ; Myocardium - pathology ; Patients ; Percutaneous Coronary Intervention - adverse effects ; Recovery of Function ; Software ; ST Elevation Myocardial Infarction - diagnostic imaging ; ST Elevation Myocardial Infarction - pathology ; ST Elevation Myocardial Infarction - physiopathology ; ST Elevation Myocardial Infarction - therapy ; ST-segment elevation myocardial infarction ; Time Factors ; Tracking ; Transluminal angioplasty ; Treatment Outcome ; Veins & arteries ; Ventricle ; Ventricular Function, Left - drug effects ; Ventricular Remodeling - drug effects
Is Part Of: Journal of cardiovascular magnetic resonance, 2020-06, Vol.22 (1), p.44-12, Article 44
Description: We aimed to evaluate the effect of early intravenous metoprolol treatment, microvascular obstruction (MVO), intramyocardial hemorrhage (IMH) and adverse left ventricular (LV) remodeling on the evolution of infarct and remote zone circumferential strain after acute anterior ST-segment elevation myocardial infarction (STEMI) with feature-tracking cardiovascular magnetic resonance (CMR). A total of 191 patients with acute anterior STEMI enrolled in the METOCARD-CNIC randomized clinical trial were evaluated. LV infarct zone and remote zone circumferential strain were measured with feature-tracking CMR at 1 week and 6 months after STEMI. In the overall population, the infarct zone circumferential strain significantly improved from 1 week to 6 months after STEMI (- 8.6 ± 9.0% to - 14.5 ± 8.0%; P < 0.001), while no changes in the remote zone strain were observed (- 19.5 ± 5.9% to - 19.2 ± 3.9%; P = 0.466). Patients who received early intravenous metoprolol had significantly more preserved infarct zone circumferential strain compared to the controls at 1 week (P = 0.038) and at 6 months (P = 0.033) after STEMI, while no differences in remote zone strain were observed. The infarct zone circumferential strain was significantly impaired in patients with MVO and IMH compared to those without (P < 0.001 at 1 week and 6 months), however it improved between both time points regardless of the presence of MVO or IMH (P < 0.001). In patients who developed adverse LV remodeling (defined as ≥ 20% increase in LV end-diastolic volume) remote zone circumferential strain worsened between 1 week and 6 months after STEMI (P = 0.036), while in the absence of adverse LV remodeling no significant changes in remote zone strain were observed. Regional LV circumferential strain with feature-tracking CMR allowed comprehensive evaluation of the sequelae of an acute STEMI treated with primary percutaneous coronary intervention and demonstrated long-lasting cardioprotective effects of early intravenous metoprolol. ClinicalTrials.gov, NCT01311700. Registered 8 March 2011 - Retrospectively registered.
Publisher: England: BioMed Central Ltd
Language: English
Identifier: ISSN: 1532-429X
ISSN: 1097-6647
EISSN: 1532-429X
DOI: 10.1186/s12968-020-00638-8
PMID: 32522198
Source: PubMed (Medline)
Geneva Foundation Free Medical Journals at publisher websites
AUTh Library subscriptions: ProQuest Central
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SpringerOpen website
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Left ventricular functional recovery of infarcted and remote myocardium after ST-segment elevation myocardial infarction (METOCARD-CNIC randomized clinical trial substudy)

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