Cardiovascular magnetic resonance in myocardial infarction with non-obstructive coronary arteries
- 作者: Pershina E.1, Shchekochikhin D.1,2,3, Shaginyan G.1, Shilova A.1,3, Sherashov A.1, Poltavskaya M.2, Isaeva S.1,2, Gilyarov M.1,2,3, Svet A.1,2, Sinitsyn V.4
-
隶属关系:
- Pirogov First City Clinical Hospital
- Sechenov First Moscow State Medical University (Sechenov University)
- Pirogov Russian National Research Medical University
- Lomonosov Moscow State University
- 期: 卷 93, 编号 4 (2021)
- 页面: 376-380
- 栏目: Original articles
- URL: https://journals.rcsi.science/0040-3660/article/view/71160
- DOI: https://doi.org/10.26442/00403660.2021.04.200676
- ID: 71160
如何引用文章
全文:
详细
Aim. To analyze diagnostic performance of cardiovascular magnetic resonance (CMR) in patients, presented with myocardial infarction with nonobstructed coronary arteries (MINOCA).
Materials ant methods. 46 consecutives patients presented with myocardial infarction without evidence of obstructive coronary disease on angiography between January, 1 2018 and October 1, 2019 were included in the study. All patients underwent CMR within 10 days after admission. MRI was performed on 1.5 T Magnetic Resonance Imaging (MRI) using comprehensive protocol (T2-images, Cine-CMR, late gadolinium enhancement (LGE)).
Results. CMR revealed myocardial infarction (MI) pattern in 14 patients (30.4%), myocarditis in 12 (26.1%), hypertrophic cardiomyopathy in 6 (13.1%). In 14 patients (30.4%) no LGE was observed. Notably in 2 patients without LGE features of takotsubo syndrome were noted. Mean age was significantly lower in patients with MI versus patient with non-ischemic causes of MINOCA (56.1±12.3 vs 64.6±12.8; p=0.04). ST elevation at admission frequency didn’t differ between MI and non-ischemic patients (35.7% vs 25.0%; p=0.76). However MI patients had significantly increased troponin level, 0.87 [0.22; 1.85] vs 0.22 [0.07; 0.38]; p=0.008. CMR allowed to establish the précised clinical diagnosis in 73.9% of the cases.
Conclusion. Clinical data doesn’t allow to differentiate ischemic or non-ischemic causes of MINOCA. However, CMR establish the correct diagnosis in most cases.
作者简介
Ekaterina Pershina
Pirogov First City Clinical Hospital
Email: isaevasaida88@mail.ru
ORCID iD: 0000-0002-3952-6865
к.м.н., рук. центра лучевой диагностики
俄罗斯联邦, MoscowDmitry Shchekochikhin
Pirogov First City Clinical Hospital; Sechenov First Moscow State Medical University (Sechenov University); Pirogov Russian National Research Medical University
Email: isaevasaida88@mail.ru
ORCID iD: 0000-0002-8209-2791
к.м.н., врач-кардиолог ГБУЗ «ГКБ №1 им Н.И. Пирогова», доц. каф. профилактической и неотложной кардиологии лечебного фак-та, рук. научно-исследовательского отд. кардиологии ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова» (Сеченовский Университет), доц. каф. интервенционной кардиологии и кардиореабилитации ФДПО ФГАОУ ВО «РНИМУ им. Н.И. Пирогова»
俄罗斯联邦, MoscowGeorgii Shaginyan
Pirogov First City Clinical Hospital
Email: isaevasaida88@mail.ru
ORCID iD: 0000-0001-9289-6104
врач-рентгенолог отд. лучевой диагностики
俄罗斯联邦, MoscowAlexandra Shilova
Pirogov First City Clinical Hospital; Pirogov Russian National Research Medical University
Email: isaevasaida88@mail.ru
ORCID iD: 0000-0002-4092-5222
к.м.н., зав. 15-м отд-нием реанимации и интенсивной терапии ГБУЗ «ГКБ №1 им Н.И. Пирогова», доц. каф. интервенционной кардиологии и кардиореабилитации ФДПО ФГАОУ ВО «РНИМУ им. Н.И. Пирогова»
俄罗斯联邦, MoscowAndrei Sherashov
Pirogov First City Clinical Hospital
Email: isaevasaida88@mail.ru
ORCID iD: 0000-0003-2220-5990
врач-кардиолог 15-го отд-ния реанимации и интенсивной терапии
俄罗斯联邦, MoscowMaria Poltavskaya
Sechenov First Moscow State Medical University (Sechenov University)
Email: isaevasaida88@mail.ru
ORCID iD: 0000-0003-4463-2897
д.м.н., проф. каф. кардиологии, функциональной и ультразвуковой диагностики
俄罗斯联邦, MoscowSaida Isaeva
Pirogov First City Clinical Hospital; Sechenov First Moscow State Medical University (Sechenov University)
编辑信件的主要联系方式.
Email: isaevasaida88@mail.ru
ORCID iD: 0000-0001-5861-904X
аспирант каф. кардиологии, функциональной и ультразвуковой диагностики ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова» (Сеченовский Университет), врач функциональной диагностики отд. функциональной диагностики ГБУЗ «ГКБ №1 им Н.И. Пирогова»
俄罗斯联邦, MoscowMihail Gilyarov
Pirogov First City Clinical Hospital; Sechenov First Moscow State Medical University (Sechenov University); Pirogov Russian National Research Medical University
Email: isaevasaida88@mail.ru
ORCID iD: 0000-0002-2870-3301
д.м.н., проф. каф. кардиологии, функциональной и ультразвуковой диагностики ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова» (Сеченовский Университет). зав. каф. интервенционной кардиологии и кардиореабилитации ФДПО ФГАОУ ВО «РНИМУ им. Н.И. Пирогова», зам. глав. врача по терапевтической помощи, рук. регионального сосудистого центра ГБУЗ «ГКБ №1 им Н.И. Пирогова»
俄罗斯联邦, MoscowAlexey Svet
Pirogov First City Clinical Hospital; Sechenov First Moscow State Medical University (Sechenov University)
Email: isaevasaida88@mail.ru
ORCID iD: 0000-0002-2278-7292
к.м.н., глав. врач ГБУЗ «ГКБ №1 им Н.И. Пирогова», доц. каф. кардиологии, функциональной и ультразвуковой диагностики
俄罗斯联邦, MoscowValentin Sinitsyn
Lomonosov Moscow State University
Email: isaevasaida88@mail.ru
ORCID iD: 0000-0002-5649-2193
д.м.н., проф., зав. каф. лучевой диагностики и терапии фак-та фундаментальной медицины, зав. отд. лучевой диагностики Медицинского научно-образовательного центра ФГБОУ ВО «МГУ им. М.В. Ломоносова», президент Российского общества рентгенологов и радиологов
俄罗斯联邦, Moscow参考
- Ibanez B, James S, Agewall S, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018;39:119-77. doi: 10.1093/eurheartj/ehx393
- DeWood MA, Spores J, Notske R, et al. Prevalence of total coronary occlusion during the early hours of transmural myocardial infarction. N Engl J Med. 1980;303:897-902. doi: 10.1056/NEJM198010163031601
- Smilowitz NR, Mahajan AM, Roe MT, et al. Mortality of Myocardial Infarction by Sex, Age, and Obstructive Coronary Artery Disease Status in the ACTION Registry-GWTG (Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With the Guidelines). Circ Cardiovasc Qual Outcomes. 2017;10(12):e003443. doi: 10.1161/CIRCOUTCOMES.116.003443
- Thygesen K, Alpert JS, Jaffe AS, et al. Group ESCSD: Fourth universal definition of myocardial infarction (2018). Eur Heart J. 2018. doi: 10.1093/eurheartj/ehy462
- Reynolds HR, Srichai MB, Iqbal SN, et al: Mechanisms of myocardial infarction in women without angiographically obstructive coronary artery disease. Circulation. 2011;124(13):1414-25. doi: 10.1161/CIRCULATIONAHA.111.026542
- Agewall S, Beltrame JF, Reynolds HR, et al. ESC working group position paper on myocardial infarction with non-obstructive coronary arteries. Eur Heart J. 2017;38(3):143-53. doi: 10.1093/eurheartj/ehw149
- Bainey KR, Welsh RC, Alemayehu W, et al. Population-level incidence and outcomes of myocardial infarction with non-obstructive coronary arteries (MINOCA): Insights from the Alberta contemporary acute coronary syndrome patients invasive treatment strategies (COAPT) study. Int J Cardiol. 2018;264:12-7. doi: 10.1016/j.ijcard.2018.04.004
- Nordenskjold AM, Baron T, Eggers KM, et al. Predictors of adverse outcome in patients with myocardial infarction with non-obstructive coronary artery (MINOCA) disease. Int J Cardiol. 2018;261:18-23. doi: 10.1016/j.ijcard.2018.03.056
- Collste O, Sörensson P, Frick M, et al. Myocardial infarction with normal coronary arteries is common and associated with normal findings on cardiovascular magnetic resonance imaging: results from the Stockholm Myocardial Infarction with Normal Coronaries study. J Intern Med. 2013;273:189-96. doi: 10.1111/j.1365-2796.2012.02567.x
- Mahmoudi M, Harden S, Abid N, et al. Troponin-positive chest pain with unobstructed coronary arteries: definitive differential diagnosis using cardiac MRI. Br J Radiol. 2012;85:e461-6.
- Dastidar AG, Baritussio A, De Garate E, et al. Prognostic Role of CMR and Conventional Risk Factors in Myocardial Infarction With Nonobstructed Coronary Arteries. JACC Cardiovasc Imaging. 2019;12(10):1973-82. doi: 10.1016/j.jcmg.2018.12.023
- Monney PA, Sekhri N, Burchell T, et al. Acute myocarditis presenting as acute coronary syndrome: role of early cardiac magnetic resonance in its diagnosis. Heart. 2011;97:1312-8. doi: 10.1136/hrt.2010.204818
- Jenab Y, Pourjafari M, Darabi F, et al. Prevalence and determinants of elevated high-sensitivity cardiac troponin T in hypertrophic cardiomyopathy. J Cardiol. 2014;63:140-4. doi: 10.1016/j.jjcc.2013.07.008