Magnetic Resonance Assessment of Left Ventricular Ejection Fraction at Any Time Post-Infarction for Prediction of Subsequent Events in a Large Multicenter STEMI Registry.

Gavara, J; Marcos-Garces, V; Lopez-Lereu, MP; Monmeneu, JV; Rios-Navarro, C; de Dios, E; Perez, N; Merenciano, H; Gabaldon, A; Canoves, J; Racugno, P; Bonanad, C; Minana, G; Nunez, J; Nunez, E; Moratal, D; Chorro, FJ; Valente, F; Lorenzatti, D; Rodriguez-Palomares, JF; Ortiz-Perez, JT; Bodi, V

Magnetic Resonance Assessment of Left Ventricular Ejection Fraction at Any Time Post-Infarction for Prediction of Subsequent Events in a Large Multicenter STEMI Registry.

BACKGROUND: Magnetic resonance imaging (MRI) is the most accurate imaging technique for left ventricular ejection fraction (LVEF) quantification, but as yet the prognostic value of LVEF assessment at any time after ST-segment elevation myocardial infarction (STEMI) for subsequent major adverse cardi...

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Autores:	Gavara, J, Marcos-Garces, V, Lopez-Lereu, MP, Monmeneu, JV, Rios-Navarro, C, de Dios, E, Perez, N, Merenciano, H, Gabaldon, A, Canoves, J, Racugno, P, Bonanad, C, Minana, G, Nunez, J, Nunez, E, Moratal, D, Chorro, FJ, Valente, F, Lorenzatti, D, Rodriguez-Palomares, JF, Ortiz-Perez, JT, Bodi, V
Tipo de recurso:	artículo
Estado:	Versión publicada
Fecha de publicación:	2022
País:	España
Institución:	INCLIVA
Repositorio:	r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:	oai:incliva.fundanetsuite.com:p15751
Acceso en línea:	https://incliva.portalinvestigacion.com/publicaciones/15751
Access Level:	acceso abierto
Palabra clave:	ST-segment elevation myocardial infarction left ventricular ejection fraction prognosis risk

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spelling	Magnetic Resonance Assessment of Left Ventricular Ejection Fraction at Any Time Post-Infarction for Prediction of Subsequent Events in a Large Multicenter STEMI Registry.Gavara, JMarcos-Garces, VLopez-Lereu, MPMonmeneu, JVRios-Navarro, Cde Dios, EPerez, NMerenciano, HGabaldon, ACanoves, JRacugno, PBonanad, CMinana, GNunez, JNunez, EMoratal, DChorro, FJValente, FLorenzatti, DRodriguez-Palomares, JFOrtiz-Perez, JTBodi, VST-segment elevation myocardial infarctionleft ventricular ejection fractionprognosisriskBACKGROUND: Magnetic resonance imaging (MRI) is the most accurate imaging technique for left ventricular ejection fraction (LVEF) quantification, but as yet the prognostic value of LVEF assessment at any time after ST-segment elevation myocardial infarction (STEMI) for subsequent major adverse cardiac event (MACE) prediction is uncertain. PURPOSE: To explore the prognostic impact of MRI-derived LVEF at any time post-STEMI to predict subsequent MACE (cardiovascular death or re-admission for acute heart failure). STUDY TYPE: Prospective. POPULATION: One thousand thirteen STEMI patients were included in a multicenter registry. FIELD STRENGTH/SEQUENCE: 1.5-T. Balanced steady-state free precession (cine imaging) and segmented inversion recovery steady-state free precession (late gadolinium enhancement) sequences. ASSESSMENT: Post-infarction MRI-derived LVEF (reduced [r]: <40%; mid-range [mr]: 40%-49%; preserved [p]: =50%) was sequentially quantified at 1 week and after >3 months of follow-up. STATISTICAL TESTS: Multi-state Markov model to determine the prognostic value of each LVEF state (r-, mr- or p-) at any time point assessed to predict subsequent MACE. A P-value <0.05 was considered to be statistically significant. RESULTS: During a 6.2-year median follow-up, 105 MACE (10%) were registered. Transitions toward improved LVEF predominated and only r-LVEF (at any time assessed) was significantly related to a higher incidence of subsequent MACE. The observed transitions from r-LVEF, mr-LVEF, and p-LVEF states to MACE were: 15.3%, 6%, and 6.7%, respectively. Regarding the adjusted transition intensity ratios, patients in r-LVEF state were 4.52-fold more likely than those in mr-LVEF state and 5.01-fold more likely than those in p-LVEF state to move to MACE state. Nevertheless, no significant differences were found in transitions from mr-LVEF and p-LVEF states to MACE state (P-value = 0.6). DATA CONCLUSION: LVEF is an important MRI index for simple and dynamic post-STEMI risk stratification. Detection of r-LVEF by MRI at any time during follow-up identifies a subset of patients at high risk of subsequent events. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY STAGE: 2.WILEY2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://incliva.portalinvestigacion.com/publicaciones/15751JOURNAL OF MAGNETIC RESONANCE IMAGINGISSN: 10531807ISSNe: 15222586reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVAinstname:INCLIVAInglésinfo:eu-repo/semantics/openAccessoai:incliva.fundanetsuite.com:p157512026-06-07T16:35:31Z
dc.title.none.fl_str_mv	Magnetic Resonance Assessment of Left Ventricular Ejection Fraction at Any Time Post-Infarction for Prediction of Subsequent Events in a Large Multicenter STEMI Registry.
title	Magnetic Resonance Assessment of Left Ventricular Ejection Fraction at Any Time Post-Infarction for Prediction of Subsequent Events in a Large Multicenter STEMI Registry.
spellingShingle	Magnetic Resonance Assessment of Left Ventricular Ejection Fraction at Any Time Post-Infarction for Prediction of Subsequent Events in a Large Multicenter STEMI Registry. Gavara, J ST-segment elevation myocardial infarction left ventricular ejection fraction prognosis risk
title_short	Magnetic Resonance Assessment of Left Ventricular Ejection Fraction at Any Time Post-Infarction for Prediction of Subsequent Events in a Large Multicenter STEMI Registry.
title_full	Magnetic Resonance Assessment of Left Ventricular Ejection Fraction at Any Time Post-Infarction for Prediction of Subsequent Events in a Large Multicenter STEMI Registry.
title_fullStr	Magnetic Resonance Assessment of Left Ventricular Ejection Fraction at Any Time Post-Infarction for Prediction of Subsequent Events in a Large Multicenter STEMI Registry.
title_full_unstemmed	Magnetic Resonance Assessment of Left Ventricular Ejection Fraction at Any Time Post-Infarction for Prediction of Subsequent Events in a Large Multicenter STEMI Registry.
title_sort	Magnetic Resonance Assessment of Left Ventricular Ejection Fraction at Any Time Post-Infarction for Prediction of Subsequent Events in a Large Multicenter STEMI Registry.
dc.creator.none.fl_str_mv	Gavara, J Marcos-Garces, V Lopez-Lereu, MP Monmeneu, JV Rios-Navarro, C de Dios, E Perez, N Merenciano, H Gabaldon, A Canoves, J Racugno, P Bonanad, C Minana, G Nunez, J Nunez, E Moratal, D Chorro, FJ Valente, F Lorenzatti, D Rodriguez-Palomares, JF Ortiz-Perez, JT Bodi, V
author	Gavara, J
author_facet	Gavara, J Marcos-Garces, V Lopez-Lereu, MP Monmeneu, JV Rios-Navarro, C de Dios, E Perez, N Merenciano, H Gabaldon, A Canoves, J Racugno, P Bonanad, C Minana, G Nunez, J Nunez, E Moratal, D Chorro, FJ Valente, F Lorenzatti, D Rodriguez-Palomares, JF Ortiz-Perez, JT Bodi, V
author_role	author
author2	Marcos-Garces, V Lopez-Lereu, MP Monmeneu, JV Rios-Navarro, C de Dios, E Perez, N Merenciano, H Gabaldon, A Canoves, J Racugno, P Bonanad, C Minana, G Nunez, J Nunez, E Moratal, D Chorro, FJ Valente, F Lorenzatti, D Rodriguez-Palomares, JF Ortiz-Perez, JT Bodi, V
author2_role	author author author author author author author author author author author author author author author author author author author author author
dc.subject.none.fl_str_mv	ST-segment elevation myocardial infarction left ventricular ejection fraction prognosis risk
topic	ST-segment elevation myocardial infarction left ventricular ejection fraction prognosis risk
description	BACKGROUND: Magnetic resonance imaging (MRI) is the most accurate imaging technique for left ventricular ejection fraction (LVEF) quantification, but as yet the prognostic value of LVEF assessment at any time after ST-segment elevation myocardial infarction (STEMI) for subsequent major adverse cardiac event (MACE) prediction is uncertain. PURPOSE: To explore the prognostic impact of MRI-derived LVEF at any time post-STEMI to predict subsequent MACE (cardiovascular death or re-admission for acute heart failure). STUDY TYPE: Prospective. POPULATION: One thousand thirteen STEMI patients were included in a multicenter registry. FIELD STRENGTH/SEQUENCE: 1.5-T. Balanced steady-state free precession (cine imaging) and segmented inversion recovery steady-state free precession (late gadolinium enhancement) sequences. ASSESSMENT: Post-infarction MRI-derived LVEF (reduced [r]: <40%; mid-range [mr]: 40%-49%; preserved [p]: =50%) was sequentially quantified at 1 week and after >3 months of follow-up. STATISTICAL TESTS: Multi-state Markov model to determine the prognostic value of each LVEF state (r-, mr- or p-) at any time point assessed to predict subsequent MACE. A P-value <0.05 was considered to be statistically significant. RESULTS: During a 6.2-year median follow-up, 105 MACE (10%) were registered. Transitions toward improved LVEF predominated and only r-LVEF (at any time assessed) was significantly related to a higher incidence of subsequent MACE. The observed transitions from r-LVEF, mr-LVEF, and p-LVEF states to MACE were: 15.3%, 6%, and 6.7%, respectively. Regarding the adjusted transition intensity ratios, patients in r-LVEF state were 4.52-fold more likely than those in mr-LVEF state and 5.01-fold more likely than those in p-LVEF state to move to MACE state. Nevertheless, no significant differences were found in transitions from mr-LVEF and p-LVEF states to MACE state (P-value = 0.6). DATA CONCLUSION: LVEF is an important MRI index for simple and dynamic post-STEMI risk stratification. Detection of r-LVEF by MRI at any time during follow-up identifies a subset of patients at high risk of subsequent events. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY STAGE: 2.
publishDate	2022
dc.date.none.fl_str_mv	2022
dc.type.none.fl_str_mv	info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion
format	article
status_str	publishedVersion
dc.identifier.none.fl_str_mv	https://incliva.portalinvestigacion.com/publicaciones/15751
url	https://incliva.portalinvestigacion.com/publicaciones/15751
dc.language.none.fl_str_mv	Inglés
language_invalid_str_mv	Inglés
dc.rights.none.fl_str_mv	info:eu-repo/semantics/openAccess
eu_rights_str_mv	openAccess
dc.publisher.none.fl_str_mv	WILEY
publisher.none.fl_str_mv	WILEY
dc.source.none.fl_str_mv	JOURNAL OF MAGNETIC RESONANCE IMAGING ISSN: 10531807 ISSNe: 15222586 reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA instname:INCLIVA
instname_str	INCLIVA
reponame_str	r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
collection	r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score	15,811543

Magnetic Resonance Assessment of Left Ventricular Ejection Fraction at Any Time Post-Infarction for Prediction of Subsequent Events in a Large Multicenter STEMI Registry.

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