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Titolo:
Visualization of discrete microinfarction after percutaneous coronary intervention associated with mild creatine kinase-MB elevation
Autore:
Ricciardi, MJ; Wu, E; Davidson, CJ; Choi, KM; Klocke, FJ; Bonow, RO; Judd, RM; Kim, RJ;
Indirizzi:
Northwestern Univ, Dept Biomed Engn, Chicago, IL 60611 USA Northwestern Univ Chicago IL USA 60611 Biomed Engn, Chicago, IL 60611 USA Northwestern Univ, Dept Med, Chicago, IL 60611 USA Northwestern Univ Chicago IL USA 60611 v, Dept Med, Chicago, IL 60611 USA Northwestern Univ, Feinberg Cardiovasc Inst, Chicago, IL 60611 USA Northwestern Univ Chicago IL USA 60611 iovasc Inst, Chicago, IL 60611 USA
Titolo Testata:
CIRCULATION
fascicolo: 23, volume: 103, anno: 2001,
pagine: 2780 - 2783
SICI:
0009-7322(20010612)103:23<2780:VODMAP>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
IRREVERSIBLE INJURY; ANGIOPLASTY; RELEASE;
Keywords:
creatine kinase; magnetic resonance imaging; angioplasty;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
14
Recensione:
Indirizzi per estratti:
Indirizzo: Kim, RJ 303 E Chicago Ave,Tarry 12-733, Chicago, IL 60611 USA 303 E Chicago Ave,Tarry 12-733 Chicago IL USA 60611 IL 60611 USA
Citazione:
M.J. Ricciardi et al., "Visualization of discrete microinfarction after percutaneous coronary intervention associated with mild creatine kinase-MB elevation", CIRCULATION, 103(23), 2001, pp. 2780-2783

Abstract

Background - Mild elevations in creatine kinase-MB (CK-MB) are common after successful percutaneous coronary interventions and are associated with future adverse cardiac events. The mechanism for CK-MB release remains unclear. A new contrast-enhanced MRI technique allows direct visualization of myonecrosis. Methods and Results - Fourteen patients without prior infarction underwentcine and contrast-enhanced MRI after successful coronary stenting; 9 patients had procedure-related CK-MB elevation, and 5 did not (negative controls). The mean age of all patients was 61 years, 36% had diabetes, 43% had multivessel coronary artery disease, and all had a normal ejection fraction. Twelve patients (86%) received an intravenous glycoprotein IIb/IIIa inhibitor; none underwent atherectomy, and all had final TIMI 3 flow. Of the 9 patients with CK-MB elevation, 5 had a minor side branch occlusion during stenting, 2 had transient ECG changes, and none developed Q-waves. The median CK-MB was 21 ng/mL (range, 12 to 93 ng/mL), which is 2.3 X the upper limit ofnormal. Contrast-enhanced MRI demonstrated discrete regions of hyperenhancement within the target vessel perfusion territory in all 9 patients. Only one developed a new wall motion abnormality. The median estimated mass of myonecrosis was 2.0 g (range, 0.7 to 12.2 g), or 1.5% of left ventricular mass (range, 0.4% to 6.0%). Hyperenhancement persisted in 5 of the 6 who underwent a repeat MRI at 3 to 12 months. No control patient had hyperenhancement. Conclusions-Contrast-enhanced MRI provides an anatomical correlate to biochemical evidence of procedure-related myocardial injury, despite the lack of ECG changes or wall motion abnormalities. Mild elevation of CK-MB after percutaneous coronary intervention is the result of discrete microinfarction.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/12/20 alle ore 15:18:50