0000000000038000
AUTHOR
Maria P. Lopez-lereu
showing 35 related works from this author
EpCAM and microvascular obstruction in patients with STEMI: a cardiac magnetic resonance study
2020
Abstract Introduction and objectives Microvascular obstruction (MVO) is negatively associated with cardiac structure and worse prognosis after ST-segment elevation myocardial infarction (STEMI). Epithelial cell adhesion molecule (EpCAM), involved in epithelium adhesion, is an understudied area in the MVO setting. We aimed to determine whether EpCAM is associated with the appearance of cardiac magnetic resonance (CMR)-derived MVO and long-term systolic function in reperfused STEMI. Methods We prospectively included 106 patients with a first STEMI treated with percutaneous coronary intervention, quantifying serum levels of EpCAM 24 hours postreperfusion. All patients underwent CMR imaging 1 w…
Texture analysis of cardiac cine magnetic resonance imaging to detect nonviable segments in patients with chronic myocardial infarction.
2017
[EN] Purpose: To investigate the ability of texture analysis to differentiate between infarcted nonviable, viable, and remote segments on cardiac cine magnetic resonance imaging (MRI). Methods: This retrospective study included 50 patients suffering chronic myocardial infarction. The data were randomly split into training (30 patients) and testing (20 patients) sets. The left ventricular myocardium was segmented according to the 17-segment model in both cine and late gadolinium enhancement (LGE) MRI. Infarcted myocardium regions were identified on LGE in short-axis views. Nonviable segments were identified as those showing LGE 50%, and viable segments those showing 0 < LGE < 50% transmural …
ST2 and left ventricular remodeling after ST-segment elevation myocardial infarction: A cardiac magnetic resonance study.
2018
Background: The association of soluble interleukin-1 receptor-like 1 (ST2) with left ventricular (LV) remodeling is unclear in patients with a first ST-segment elevation myocardial infarction (STEMI). The objective of this work was to assess the relationship between ST2, a marker of inflammation, and cardiac magnetic resonance (CMR) imaging-derived LV remodeling after a first STEMI. Methods: We prospectively evaluated 109 patients with a first STEMI treated with primary percutaneous coronary intervention who had ST2 assessed 24 h post-reperfusion. All patients underwent CMR imaging 1 week and 6 months after STEMI. The independent associations between ST2, LV diastolic and systolic volume in…
EpCAM y obstrucción microvascular en pacientes con un IAMCEST: estudio con resonancia magnética cardiaca
2022
Resumen Introduccion y objetivos La obstruccion microvascular (OMV) se asocia negativamente con la estructura cardiaca y el pronostico de los pacientes tras un infarto agudo de miocardio con elevacion del segmento ST (IAMCEST). El factor epithelial cell adhesion molecule (EpCAM), implicado en la cohesion de las celulas epiteliales, esta poco estudiado en el contexto de la OMV. Por ello, el objetivo de este estudio es evaluar en una cohorte de pacientes con IAMCEST la asociacion entre la concentracion de EpCAM circulante con la extension de la OMV, determinada por resonancia magnetica cardiaca (RMC), y la funcion sistolica en fases cronicas. Metodos Se incluyo prospectivamente a 106 paciente…
Long-term prognostic value of a comprehensive assessment of cardiac magnetic resonance indexes after an ST-segment elevation myocardial infarction.
2013
Abstract Introduction and objectives A variety of cardiac magnetic resonance indexes predict mid-term prognosis in ST-segment elevation myocardial infarction patients. The extent of transmural necrosis permits simple and accurate prediction of systolic recovery. However, its long-term prognostic value beyond a comprehensive clinical and cardiac magnetic resonance evaluation is unknown. We hypothesized that a simple semiquantitative assessment of the extent of transmural necrosis is the best resonance index to predict long-term outcome soon after a first ST-segment elevation myocardial infarction. Methods One week after a first ST-segment elevation myocardial infarction we carried out a comp…
The Sum of ST-Segment Elevation Is the Best Predictor of Microvascular Obstruction in Patients Treated Successfully by Primary Percutaneous Coronary …
2010
Introduction and objectives The usefulness of ST-segment elevation resolution (STR) for predicting epicardial reperfusion is well established. However, it is still not clear how ST-segment changes are related to microvascular obstruction (MVO) observed by cardiovascular magnetic resonance (CMR) after primary percutaneous coronary intervention (pPCI) for ST-segment elevation myocardial infarction (STEMI). Methods The study involved 85 consecutive patients admitted for a first STEMI and treated by pPCI who had a patent infarct-related artery. An ECG was recorded on admission and 90 min and 6, 24, 48 and 96 h after pPCI. Thereafter, STR and the sum of ST-segment elevation (sumSTE) in all leads…
Valor pronóstico de la isquemia miocárdica y la necrosis en pacientes con la función ventricular izquierda deprimida: un registro multicéntrico con r…
2014
Resumen Introduccion y objetivos No se conoce el valor pronostico incremental que aporta la isquemia miocardica inducible respecto a la necrosis determinada por resonancia magnetica cardiaca de estres en pacientes con funcion ventricular izquierda deprimida. Se determina el valor pronostico de la necrosis y la isquemia en pacientes con funcion ventricular izquierda deprimida remitidos a exploracion por resonancia magnetica de estres con perfusion de dipiridamol. Metodos En un registro multicentrico basado en el uso de resonancia magnetica de estres, se determino la presencia (≥ 2 segmentos) de realce tardio de contraste y defectos de perfusion y su asociacion con eventos mayores (muerte car…
Contractile Reserve and Extent of Transmural Necrosis in the Setting of Myocardial Stunning: Comparison at Cardiac MR Imaging
2010
To perform a comparison of cardiac magnetic resonance (MR) imaging-derived ejection fraction (EF) during low-dose dobutamine infusion (EF(D)) with the extent of segments with transmural necrosis in more than 50% of their wall thickness (ETN) for the prediction of major adverse cardiac events (MACEs) and late systolic recovery soon after a first ST-segment elevation myocardial infarction (STEMI).Institutional ethics committee approval and written informed consent were obtained. One hundred nineteen consecutive patients with a first STEMI, a depressed left ventricular EF, and an open infarct-related artery underwent MR imaging at 1 week after infarction. EF(D) and ETN (by using a 17-segment m…
Comparative Analysis of Tagging and Feature-Tracking Cardiac MRI Techniques for the Evaluation of Cardiac Deformation
2020
[EN] Currently, there is a high prevalence of cardiovascular diseases, being the leading cause of mortality worldwide. Thus, a rapid and effective evaluation of the heart is increasingly relevant to diagnose the patient early and achieve appropriate treatment. For this reason, this study aims to compare myocardial deformation parameters such as circumferential strain (segmental, base, mid, apical and global) and global torsion values by the CMR tissue tagging reference technique in SPAMM cine images and the promising feature-tracking technique in b-SSFP cine images, in 31 healthy subjects and 35 patients diagnosed with infarct. The results obtained showed that there is a high agreement in t…
Ventricular structural changes in patients with sleep-disordered breathing (SDB) and myocardial infarction
2018
Obstructive sleep apnea (OSA) is associated with cardiovascular diseases. Aim: To analyze structural parameters of myocardial damage in patients presenting with acute coronary syndrome (ACS) and its relationship with OSA severity. Method: This is a prospective, observational study in patients with a first acute myocardial infarction (MI) treated by percutaneous coronary intervention (PCI). Cardiovascular magnetic resonance (CMR) studies were performed at 3 days and 6 months. Eligible patients underwent a polysomnography within 30 days after PCI. Quantitative data were expressed as mean±SD. Linear regression analysis was used to describe associations between infarct characteristics and OSA. …
Prognostic implications of dipyridamole cardiac MR imaging: a prospective multicenter registry
2011
Purpose: To evaluate dipyridamole cardiac magnetic resonance (MR) imaging in the prediction of major events (MEs) in patients with ischemic chest pain in a large multicenter registry. Materials and Methods: Institutional ethics committee approval and written informed consent were obtained. A total of 1722 patients who were undergoing cardiac MR imaging for chest pain were included. Wall motion abnormalities (WMAs) at rest, hyperemia perfusion defect (PD), late gadolinium enhancement (LGE), and inducible WMA were analyzed (abnormal if more than one abnormal segment was seen) with the 17-segment model. A cardiac MR categorization was created: category 1, no PD, LGE, or inducible WMA; category…
PSPU-Net for Automatic Short Axis Cine MRI Segmentation of Left and Right Ventricles
2020
[EN] Characterization of the heart anatomy and function is mostly done with magnetic resonance image cine series. To achieve a correct characterization, the volume of the right and left ventricle need to be segmented, which is a timeconsuming task. We propose a new convolutional neural network architecture that combines U-net with PSP modules (PSPU-net) for the segmentation of left and right ventricle cavities and left ventricle myocardium in the diastolic frame of short-axis cine MRI images and compare its results against a classic 3D U-net architecture. We used a dataset containing 399 cases in total. The results showed higher quality results in both segmentation and final volume estimati…
Hypoxic burden and angiogenic factors in patients with myocardial infarction and obstructive sleep apnea
2019
Introduction: The amount and severity of hypoxia have been related to risk of cardiovascular events. Aim: To determine the relationship between nocturnal hypoxic burden and pro- angiogenic factors in patients with obstructive sleep apnea (OSA) and myocardial infarction (MI). Method: A prospective, observational study in patients with a first acute MI. Eligible patients underwent a polysomnography within 30 days after MI, and a serum blood sample was drawn in order to measure a panel of angiogenic factors by Luminex technology. A hypoxic burden index (HBI) was calculated as the integral area under the desaturation curve (obtained by calculating the integral of the oxygen saturation reduction…
Resonancia magnética cardiaca de estrés para predecir mortalidad y toma de decisiones: registro de 2.496 pacientes mayores con síndrome coronario cró…
2022
Resumen Introduccion y objetivos El tratamiento del paciente mayor con sindrome coronario cronico (SCC) es un reto. Se exploro el valor pronostico y la utilidad para la toma de decisiones de la carga isquemica determinada mediante resonancia magnetica cardiaca (RMC) de estres con vasodilatador en pacientes mayores con SCC. Metodos Se incluyo a 2.496 pacientes mayores de 70 anos estudiados con una RMC de estres con vasodilatador por SCC conocido o sospechado. La carga isquemica (numero de segmentos con deficit de perfusion inducido por el estres) se calculo siguiendo el modelo de 17 segmentos. Posteriormente se analizo de manera retrospectiva su asociacion con la mortalidad por cualquier cau…
Differentiation between acute and chronic myocardial infarction by means of texture analysis of late gadolinium enhancement and cine cardiac magnetic…
2017
[EN] The purpose of this study was to differentiate acute from chronic myocardial infarction using machine learning techniques and texture features extracted from cardiac magnetic resonance imaging (MRI). The study group comprised 22 cases with acute myocardial infarction (AMI) and 22 cases with chronic myocardial infarction (CMI). Cine and late gadolinium enhancement (LGE) MRI were analyzed independently to differentiate AMI from CMI. A total of 279 texture features were extracted from predefined regions of interest (ROIs): the infarcted area on LGE MRI, and the entire myocardium on cine MRI. Classification performance was evaluated by a nested cross-validation approach combining a feature…
Automatic left ventricle volume calculation with explainability through a deep learning weak-supervision methodology
2021
[EN] Background and objective: Magnetic resonance imaging is the most reliable imaging technique to assess the heart. More specifically there is great importance in the analysis of the left ventricle, as the main pathologies directly affect this region. In order to characterize the left ventricle, it is necessary to extract its volume. In this work we present a neural network architecture that is capable of directly estimating the left ventricle volume in short axis cine Magnetic Resonance Imaging in the end-diastolic frame and provide a segmentation of the region which is the basis of the volume calculation, thus offering explain-ability to the estimated value. Methods: The network was des…
La suma de la elevación del segmento ST predice mejor la obstrucción microvascular en pacientes tratados con éxito con una intervención coronaria per…
2010
Introduccion y objetivos La utilidad de la resolucion del segmento ST (RST) para la prediccion de la reperfusion epicardica esta bien establecida. La asociacion de los cambios del segmento ST con la obstruccion microvascular (OMV) observada en la resonancia magnetica cardiovascular (RMC) tras una intervencion coronaria percutanea primaria (ICPp) en el infarto de miocardio con elevacion del ST (IMEST) no se ha aclarado todavia. Metodos Estudiamos a 85 pacientes consecutivos ingresados por un primer IMEST y tratados con una ICPp que tenian una arteria relacionada con el infarto permeable. Se registro un ECG al ingreso, tras 90 min y tras 6, 24, 48 y 96 h de la ICPp. Se calculo la RST y la sum…
Texture analysis for infarcted myocardium detection on delayed enhancement MRI
2017
Detection of infarcted myocardium in the left ventricle is achieved with delayed enhancement magnetic resonance imaging (DE-MRI). However, manual segmentation is tedious and prone to variability. We studied three texture analysis methods (run-length matrix, co-occurrence matrix, and autoregressive model) in combination with histogram features to characterize the infarcted myocardium. We evaluated 10 patients with chronic infarction to select the most discriminative features and to train a support vector machine (SVM) classifier. The classifier model was then used to segment five human hearts from the STACOM DE-MRI challenge at MICCAI 2012. The Dice coefficient was used to compare the segmen…
Microvascular perfusion 1 week and 6 months after myocardial infarction by first-pass perfusion cardiovascular magnetic resonance imaging
2006
To characterise the evolution of myocardial perfusion during the first 6 months after myocardial infarction by first-pass perfusion cardiovascular magnetic resonance imaging (CMR) and determine its significance.Prospective cohort design.Single-centre study in a teaching hospital in Spain.40 patients with a first ST-elevation myocardial infarction, single-vessel disease and thrombolysis in myocardial infarction (TIMI) grade 3 flow (stent in 33 patients) underwent rest and low-dose dobutamine CMR 7 (SD 1) and 184 (SD 11) days after infarction. Microvascular perfusion was assessed at rest by visual assessment and quantitative analysis of first-pass perfusion CMR. Of the 640 segments, 290 segme…
Stress cardiac magnetic resonance for mortality prediction and decision-making: registry of 2496 elderly patients with chronic coronary syndrome
2022
Abstract Introduction and objectives The management of elderly patients with chronic coronary syndrome (CCS) is challenging. We explored the prognostic value and usefulness for decision-making of ischemic burden determined by vasodilator stress cardiac magnetic resonance (CMR) imaging in elderly patients with known or suspected CCS. Methods The study group comprised 2496 patients older than 70 years who underwent vasodilator stress CMR for known or suspected CCS. The ischemic burden (number of segments with stress-induced perfusion deficit) was calculated following the 17-segment model. Subsequently, we retrospectively analyzed its association with all-cause mortality and the effect of CMR-…
Usefulness of a Comprehensive Cardiovascular Magnetic Resonance Imaging Assessment for Predicting Recovery of Left Ventricular Wall Motion in the Set…
2005
ObjectivesWe sought to evaluate the usefulness of a comprehensive assessment of four cardiovascular magnetic resonance imaging (CMR)-derived myocardial viability indexes in the setting of myocardial stunning.BackgroundCardiovascular magnetic resonance imaging allows the simultaneous assessment of several viability indexes.MethodsWe studied 40 patients with a first ST-segment elevation myocardial infarction (MI) and an open infarct-related artery. At the first week, using CMR, wall motion (WM), and four viability indexes were determined: wall thickness, WM improvement with low-dose dobutamine, perfusion, and transmural extent of necrosis. We created a comprehensive score based on the presenc…
Analysis of the extension of Q-waves after infarction with body surface map: relationship with infarct size.
2006
We aimed to characterize the extension of Q-waves after a first ST-segment elevation myocardial infarction using body surface map (BSM) and its relationship with infarct size quantified with cardiovascular magnetic resonance imaging (CMR).Thirty-five patients were studied 6 months after a first ST-segment elevation myocardial infarction (23 anterior, 12 inferior). All cases had single-vessel disease and an open artery. The extension of Q-waves was analyzed by means of a 64-lead BSM. Infarct size was quantified with CMR. Absence of Q-waves in BSM was observed in 5 patients (14%), 2 of whom (40%) had1 segment with transmural necrosis. Absence of Q-waves in 12-lead ECG was observed in 8 patien…
Limitaciones del blush miocárdico para el análisis de la perfusión miocárdica en pacientes con infarto agudo de miocardio y flujo TIMI 3
2006
Introduccion y objetivos Analizamos la variabilidad en la medicion del indice angiografico de blush entre un hospital universitario y un laboratorio central independiente, asi como su correlacion con la perfusion analizada mediante ecocardiografia miocardica con contraste intracoronario (EMC) y con la funcion ventricular a los 6 meses Metodos Se incluyo en el estudio a 40 pacientes con un primer infarto agudo de miocardio con elevacion del segmento ST, enfermedad de un vaso y arteria relacionada con el infarto abierta. La perfusion se cuantifico por angiografia (mediana quinto dia, rango de 3-7) mediante el blush miocardico en nuestro laboratorio y en un laboratorio central independiente. S…
[Myocardial echocardiography with intracoronary injection of contrast in post-infarction patients. Implications and comparison with angiography and m…
2004
We analyzed the safety and feasibility of myocardial echocardiography with intracoronary injection of contrast, its effect on left ventricular remodeling and systolic function, and its relationship with angiography and magnetic resonance imaging (MRI) for the evaluation of post-infarction coronary microcirculation.Thirty patients with a first ST-elevation myocardial infarction and a patent infarct-related artery were studied. Mean perfusion score of the infarcted area was analyzed with myocardial echocardiography. TIMI and Blush grades (angiography) were determined. Mean perfusion score (MRI-perfusion), end-diastolic volume index and ejection fraction were determined with MRI. At 6 months a…
Valor diagnóstico adicional de la disfunción sistólica inducida para la detección de enfermedad coronaria mediante resonancia magnética cardiaca de e…
2009
Introduccion y objetivos La perfusion con dipiridamol en resonancia magnetica cardiaca (RMC) de estres se utiliza para la deteccion de enfermedad de las arterias coronarias (EAC). Sin embargo, se carece de informacion sobre el valor diagnostico de la disfuncion sistolica (DS) inducida con dipiridamol. Este estudio se centra en investigar si la DS inducida aporta un valor diagnostico adicional junto con la perfusion para la deteccion de las EAC. Metodos Se sometio a 166 pacientes a una RMC con dipiridamol y a una angiografia coronaria cuantitativa. Se definio EAC para valores ≥ 70% de estenosis. Se analizo la extension de la DS en reposo, la DS con dipiridamol, la DS inducida, el deficit de …
Valor pronóstico a largo plazo del análisis completo de los índices de resonancia magnética cardiaca tras un infarto de miocardio con elevación del s…
2013
Resumen Introduccion y objetivos Se ha demostrado el valor pronostico de varios indices de resonancia magnetica cardiaca a medio plazo tras un infarto agudo de miocardio con elevacion del segmento ST. La extension de la necrosis transmural permite una prediccion simple y exacta de viabilidad miocardica. Sin embargo, se desconoce su valor pronostico a largo plazo mas alla de una completa evaluacion clinica y por resonancia. Nuestra hipotesis es que la evaluacion semicuantitativa de la extension de la necrosis transmural es el mejor indice de resonancia para predecir el pronostico a largo plazo tras un infarto con elevacion del segmento ST. Metodos Se realizo un estudio cuantitativo con reson…
Estudio de perfusión en pacientes postinfarto mediante ecografía miocárdica con inyección de contraste intracoronario. Implicaciones y relación con l…
2004
38 Objetivos. Analizamos la aplicabilidad y seguridad de la ecografia miocardica con inyeccion intracoronaria de contraste, su papel en la remodelacion ventricular y en la funcion sistolica, asi como su relacion con la angiografia y la resonancia magnetica para valorar la microcirculacion coronaria postinfarto. Pacientes y metodo. Se estudio a 30 pacientes con un primer infarto de miocardio con elevacion del segmento ST y arteria responsable abierta. Con inyeccion intracoronaria de contraste se determino la puntuacion media de perfusion en la zona infartada. Mediante angiografia se cuantificaron los grados TIMI y Blush. Se utilizo la resonancia magnetica para determinar la puntuacion media …
Limitations of Myocardial Blush Grade in the Evaluation of Myocardial Perfusion in Patients With Acute Myocardial Infarction and TIMI Grade 3 Flow
2006
Introduction and objectives An analysis was made of variability in the measurement of the angiographic index blush between a university hospital and an independent core laboratory, as well as its correlation with perfusion analised by intracoronary myocardial contrast echocardigraphy (MCE) and the ventricular function at the sixth month. Methods The study comprised 40 patients with a first ST-segment elevation myocardial infarction, single-vessel disease and open infarct-related artery. Perfusion was quantified by angiography (median fifth day, range 3-7) with blush in our laboratory and in an independent core laboratory. MCE was performed. Ejection fraction at the sixth month was determine…
Perfusión miocárdica alterada tras un infarto en pacientes con flujo TIMI 3 mantenido. ¿Sólo un fenómeno agudo?
2007
Introduccion y objetivos Se ha senalado que la perfusion anormal analizada mediante resonancia magnetica cardiaca (RMC) es una alteracion transitoria de la microcirculacion despues de un infarto agudo de miocardio (IAM) con flujo TIMI 3. Planteamos la hipotesis de que las alteraciones de la perfusion miocardica pueden persistir en los meses siguientes. Metodos Estudiamos 47 pacientes con un primer IAM y flujo TIMI 3 mantenido mediante ecografia miocardica con inyeccion intracoronaria de contraste (EMC) en la primera semana y el sexto mes postinfarto. Se considero que habia perfusion anormal mediante EMC si habia mas de un segmento hipoperfundido. Resultados En la primera semana 20 pacientes…
Characterization of normal regional myocardial function by MRI cardiac tagging
2013
Purpose The aim of this study was to establish reference values for segmental myocardial strain measured by magnetic resonance (MR) cardiac tagging in order to characterize the regional function of the heart. Material and Methods We characterized the left ventricular (LV) systolic deformation in 39 subjects (26 women and 13 men, age 58.8 ± 11.6 years) whose cardiological study had not revealed any significant abnormality. The deformation was measured from MR-tagged (Siemens 1.5T MR) images using an algorithm based on sine wave modeling. Circumferential and radial peak systolic strain values along with the torsion angle and circumferential-longitudinal (CL) shear were determined in 16 LV seg…
Abnormal Myocardial Perfusion After Infarction in Patients With Persistent TIMI Grade-3 Flow. Only an Acute Phenomenon?
2007
Introduction and objectives It has been suggested that abnormal perfusion as derived from cardiovascular magnetic resonance imaging (CMR) is a transient dysfunction of microcirculation after myocardial infarction (MI) with TIMI 3 flow. We hypothesized that defects of myocardial perfusion may persist during the following months. Methods Forty-seven patients with MI and sustained TIMI 3 flow underwent intracoronary myocardial contrast echocardiography (MCE) 1 week and 6 months after infarction. Abnormal perfusion by MCE was regarded as >1 hypoperfused segment. Results At one week, 20 patients showed abnormal perfusion as derived from MCE. At six months 10 patients displayed chronic abnormal p…
Prognostic and therapeutic implications of dipyridamole stress cardiovascular magnetic resonance on the basis of the ischaemic cascade
2008
To determine the prognostic and therapeutic implications of stress perfusion cardiovascular magnetic resonance (CMR) on the basis of the ischaemic cascade.Single centre study in a teaching hospital in Spain.Dipyridamole stress CMR was performed on 601 patients with ischaemic chest pain and known or suspected coronary artery disease. On the basis of the ischaemic cascade, patients were categorised in C1 (no evidence of ischaemia, n = 354), C2 (isolated perfusion deficit at stress first-pass perfusion imaging, n = 181) and C3 (simultaneous perfusion deficit and inducible wall motion abnormalities, n = 66). CMR-related revascularisation (n = 102, 17%) was defined as the procedure prompted by t…
Linfopenia post-reperfusión y obstrucción microvascular en el infarto agudo de miocardio con elevación del segmento ST
2009
Introduccion y objetivos La obstruccion microvascular tras un infarto agudo de miocardio con elevacion del segmento ST se asocia a mal pronostico. La fisiopatologia de este fenomeno no esta totalmente definida. Analizamos las implicaciones de la linfopenia post-reperfusion en la existencia de obstruccion microvascular. Metodos Estudiamos prospectivamente a 212 pacientes que habian sufrido un primer infarto agudo de miocardio con elevacion del segmento ST reperfundido con agentes tromboliticos o con angioplastia primaria y con la arteria responsable abierta. Cuantificamos de manera seriada las cifras de linfocitos, neutrofilos y monocitos. Usamos la resonancia magnetica cardiaca para determi…
Post-Reperfusion Lymphopenia and Microvascular Obstruction in ST-Segment Elevation Acute Myocardial Infarction
2009
The presence of microvascular obstruction after ST-segment elevation acute myocardial infarction is associated with a poor outcome. The pathophysiology of this process has not been fully defined. The aim of this study was to investigate the relationship between post-reperfusion lymphopenia and microvascular obstruction.This prospective study involved 212 patients with a first ST-segment elevation acute myocardial infarction who underwent reperfusion with thrombolytic agents or primary angioplasty and who had an open infarct-related artery. Serial measurements of lymphocyte, neutrophil and monocyte counts were taken. Cardiac magnetic resonance was used to detect microvascular obstruction dur…
Resultados de la estrategia farmacoinvasiva y de la angioplastia primaria en la reperfusión del infarto con elevación del segmento ST. Estudio con re…
2011
[EN] Introduction and objectives: Pharmacoinvasive strategy represents an attractive alternative to primary angioplasty. Using cardiovascular magnetic resonance imaging we compared the left ventricular outcome of the pharmacoinvasive strategy and primary angioplasty for the reperfusion of ST-segment elevation myocardial infarction. Methods: Cardiovascular magnetic resonance was performed 1 week and 6 months after infarction in two consecutive cohorts of patients included in a prospective university hospital ST-segment elevation myocardial infarction registry. During the period 2004-2006, 151 patients were treated with pharmacoinvasive strategy (thrombolysis followed by routine non-immediate…