Prognostic value of cardiac magnetic resonance imaging in patients with acute myocardial infarction: results of a midterm follow-up

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Purpose . To evaluate the prognostic value of contrast-enhanced magnetic resonance imaging (MRI) performed early after acute myocardial infarction (AMI) in the development of adverse outcomes during the follow-up period of 12 months. Materials and methods. This observational study consecutively enrolled 88 patients admitted to the cardiology emergency department with a primary diagnosis of AMI, with or without ST-segment elevation. A combined endpoint was formed at the end of the 12-month follow-up period, including 'hard' clinical outcomes. All patients underwent cardiac magnetic resonance imaging (CMR) with contrast on days 4–7 after admission. CMR was used to measure the main volumetric indices of the heart chambers and their function, as well as the tissue characteristics of the myocardium, such as edema percentage, infarct size, and the grey zone of myocardial infarction, expressed as a percentage and in grams of left ventricular myocardial mass (LVMM). Results . The follow-up period was 357 ± 23 days. Endpoint (EP) data were obtained from all 88 patients in the sample (100%). A total of 16 patients (18%) were found to have achieved the combined EP. Myocardial infarct size, as expressed by LV myocardial mass and LV end-diastolic index, is an independent predictor of the development of adverse cardiovascular events in the mid-term follow-up period in patients undergoing acute myocardial infarction. The prognostic model based on clinical data and MRI scans had a higher prognostic value, but this did not reach statistical significance in the sample of patients considered. Meanwhile, the prognostic models based on clinical risk factors for adverse cardiovascular events (ACE) (sex, age and GRACE risk) and those based on CMR data did not differ significantly in terms of informativeness. Conclusion . Cardiac structural and functional indices obtained by CMR are associated with the severity of the disease at the hospital stage in patients after an acute myocardial infarction and can be used as prognostic predictors of adverse cardiovascular events in the medium term. These indices can also be used as prognostic predictors of adverse cardiovascular events in the medium term.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.