Early defects identified by computed tomography angiography are associated with left ventricular dysfunction and exercise intolerance following acute myocardial infarction |
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Authors: | Ken Kongoji Kihei Yoneyama Kohei Koyama Takanobu Mitarai Ryo Kamijima Keisuke Kida Yasuyuki Kobayashi Kazuto Omiya Yoshihiro J. Akashi |
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Affiliation: | 1. Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan 2. Department of Radiology, St. Marianna University School of Medicine, Kawasaki, Japan
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Abstract: | Purpose We evaluated the influence of early defects (EDs) in the infarcted myocardium after reperfusion, detected by computed tomography angiography (CTA), on cardiac function and exercise capacity in the chronic phase. Materials and methods We retrospectively analyzed 48 acute myocardial infarction (AMI) patients who underwent both CTA using 64-slice multidetector CT within 14 ± 6 days and cardiopulmonary exercise testing within 3 months after AMI onset between 2005 and 2007. The patients were divided into 2 groups: the EDs <75 % or EDs ≥75 % group. Brain natriuretic peptide (BNP) levels and ejection fraction (EF) were measured 6 months after AMI onset. Results The minute ventilation–carbon dioxide production slope was significantly higher in the EDs ≥75 % group (28.7 ± 4.9) than in the EDs <75 % group (25.1 ± 3.1, P = 0.048). EF at 6 months was significantly lower in the EDs ≥75 % group (48.1 ± 12.0 %) than in the EDs <75 % group (56.8 ± 10.0 %, P = 0.01). Log of BNP levels was higher in the EDs ≥75 % group than in the EDs <75 % group (P < 0.001). Conclusion EDs detected by CTA in the acute phase of AMI influenced myocardial dysfunction and exercise intolerance in the chronic phase. |
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