Delayed Enhancement Magnetic Resonance Imaging Quantitatively Evaluate The Infarcted Mass On Emergency And Elective Percutaneous Coronary Interention

Objective:The main purpose of this experiment was to quantitatively compare the recovery matter of infarcted mass after emergency and elective percutaneous coronary interention (PCI) on delayed enhancement magnetic resonance imaging (DE-MRI) by using computer-assisted volume method (CAVM) and visual scoring method (VSM) during patients with acute myocardial infarction (AMI), Then revealed the importance of emergency PCI. And to study the relationships between the infarcted mass and the VSM scores, the abnormal wall motion scores and the left ventricular functions. Methods:1.24 patients from Cardiac Care Unit (CCU) with a first, ST-segment elevation patterns of AMI from September 2009 to March 2011 were studied.11 patients of them were treated with undergoing emergency PCI within 12 hours after infarction while the others with undergoing elective PCI within 6-8 days after infarction. Then the former was the group of emergency PCI,and the latter was the group of elective PCI. In two groups other treatment of patients was exactly the same.2. All patients were treated with emergency PCI or elective PCI, and recorded Creatine kinase isoenzyme MB(CK-MB) and Cardiac TroponinⅠ(cTnI) peak. And first time in about 7-10 days underwent the line short-axis ECG-gated, multi-SSFP cine and DE-MRI using a 1.5T magnetic resonance scanner: immediately after injection of contrast agent first pass perfusion imaging, and then delayed for 5 minutes,10 minutes,15 minutes, detected infarction location, mass, transmural extent, the abnormal wall motion, and left ventricular functions according segment cardiac module. And checked by the same way after the 3-month. Analysis of the related indicators.3. Statistical methods:The results were showed by means plus or subtracting standard, the same statistical indicators of the groups was used paired T-test, the two groups was used T-test, the differents used multiple linear regression analysis. P<0.05 was considered statistically significant. The software SPSS 13.0 for windows was used to analyze the data. Results:1.Comparison general conditions of patients general conditions, there was no significant difference between the two groups (P>0.05); 2. Group with emergency PCI the mean CK-MB peak was (12.43±6.41) ng/ml, and with elective PCI the mean CK-MB peak was (13.23±5.98) ng/ml, there was no significant difference between the two groups (P>0.05); Group with emergency PCI the mean cTnI peak was (18.43±7.32) ng/ml, and with elective PCI the mean cTnI peak was (20.23±6.18) ng/ml, there was no significant difference between the two groups (P>0.05).3.The infarcted mass, the VSM scores, the abnormal wall motion scores and the left ventricular functions of follow-up compared with scores for the first time, had improved measured by cardiac magnetic resonance imaging(CMRI) on two groups. The infarcted mass, the VSM scores, the abnormal wall motion scores, end-diastolic volume(EDV) and end-systolic volume(ESV) of the emergency PCI group compared with scores of the elective PCI had improved measured by cardiac magnetic resonance imaging(CMRI) on the first time and the second time, thus left ventricle ejection fraction(LVEF) of the emergency PCI group compared with scores of the elective PCI had improved measured by cardiac magnetic resonance imaging(CMRI) on the first time, but follow-up showed no difference (p>0.05) on two groups.4. The infarcted mass compared the VSM scores, the abnormal wall motion scores, the EDV and the ESV were positively related for the first time on two groups, and LVEF was negative related (P<0.05). The infarcted mass compared the VSM scores, the abnormal wall motion scores, the EDV and the ESV were positively related for the second time on two groups(P<0.05), and LVEF was not related (P>0.05). Conclusion:1. Acute myocardial infarction patients with stents is safe and feasible on examination of CMRI in acute stage.2. Drug-eluting stents(DES) in patients made no stent artifacts on examination of CMRI in early stage.3. Delayed enhancement magnetic resonance imaging (DE-MRI) by using computer-assisted volume method (CAVM) could objectively, accurately and quantitatively evaluate of the infarcted mass.4. VSM scores highly correlated with the infarcted mass, could be quantitatively evaluate the size.5. Elective PCI treatment during 6-8 days maight reduce the quality of myocardial infarction, reduce the VSM scores, improve cardiac function.6. The treatment of acute myocardial infarction myocardial infarction with emergency PCI could significantly reduce the quality of myocardial infarction and reduce VSM scores, improve heart function, better than the treatment of elective PCI.