T-Wave Alternans Is Linked to Microvascular Obstruction and to Recurrent Coronary Ischemia After Myocardial Infarction

被引:1
|
作者
Flore, V. [1 ,2 ]
Claus, P. [3 ]
Vos, M. A. [4 ]
Vandenberk, B. [1 ]
Van Soest, S. [1 ]
Sipido, K. R. [1 ]
Adriaenssens, T. [2 ]
Bogaert, J. [5 ]
Desmet, W. [2 ]
Willems, R. [1 ,2 ]
机构
[1] Univ Leuven, Dept Cardiovasc Dis, Div Expt Cardiol, Leuven, Belgium
[2] Univ Hosp Leuven, Div Clin Cardiol, B-3000 Leuven, Belgium
[3] Univ Leuven, Dept Cardiovasc Dis, Div Imaging & Cardiovasc Dynam, Leuven, Belgium
[4] Univ Utrecht, Univ Med Ctr Utrecht, Div Heart & Lungs, Dept Med Physiol, Utrecht, Netherlands
[5] Univ Leuven, Dept Imaging & Pathol, Leuven, Belgium
关键词
ST segment elevation myocardial infarction; Non-invasive risk stratification; t-wave alternans; Cardiac magnetic resonance imaging; Microvascular obstruction; VENTRICULAR TACHYARRHYTHMIC EVENTS; SUDDEN CARDIAC DEATH; ST-SEGMENT; MAGNETIC-RESONANCE; RISK-ASSESSMENT; ASSOCIATION; GUIDELINE; IMPACT;
D O I
10.1007/s12265-015-9649-x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The purpose of this study is to investigate the relationship between T-wave alternans (TWA), infarct size and microvascular obstruction (MVO) and recurrent cardiac morbidity after ST elevation myocardial infarction (STEMI). One hundred six patients underwent TWA testing 1-12 months and 57 patients underwent cardiac magnetic resonance imaging (MRI) in the first 2-4 days after STEMI. During follow-up (3.5 +/- 0.5 years), death (n = 2), ventricular tachycardia (n = 3), supraventricular tachycardia (n = 4), heart failure (n = 3) and recurrent coronary ischemia (n = 25) were observed. After multivariate analysis, positive TWA (HR2.59, CI1.10-6.11, p0.024) and larger MVO (HR1.08, CI1.01-1.16, p0.034) were associated with recurrent angina or ACS. Presence of MVO was correlated with TWA (Spearman rho 0.404, p0.002) and the impairment of LVEF (-0.524, p < 0.001). Patients after STEMI remain at a high risk of symptoms of coronary ischemia. The presence of MVO and TWA 1-12 months after STEMI is related to each other and to recurrent angina or ACS.
引用
收藏
页码:484 / 492
页数:9
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