Prognostic Value of Integrated Assessment of Cardiac Magnetic Resonance-Derived Global Coronary Flow Reserve and Cardiopulmonary Exercise Testing-Derived Peak Oxygen Consumption in Patients With Acute Myocardial Infarction

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  • Sugiyama Tomoyo
    Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital Department of Cardiovascular Medicine, Tokyo Medical and Dental University
  • Kanaji Yoshihisa
    Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
  • Hoshino Masahiro
    Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
  • Hada Masahiro
    Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
  • Hanyu Yoshihiro
    Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
  • Nagamine Tatsuhiro
    Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
  • Nogami Kai
    Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
  • Ueno Hiroki
    Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
  • Matsuda Kazuki
    Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
  • Sayama Kodai
    Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
  • Sakamoto Tatsuya
    Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
  • Usui Eisuke
    Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
  • Wakasa Nobutaka
    Department of Clinical Laboratory, Tsuchiura Kyodo General Hospital
  • Umino Takashi
    Department of Clinical Laboratory, Tsuchiura Kyodo General Hospital
  • Hamano Ippei
    Department of Rehabilitation, Tsuchiura Kyodo General Hospital
  • Yamamoto Manabu
    Department of Rehabilitation, Tsuchiura Kyodo General Hospital
  • Yonetsu Taishi
    Department of Cardiovascular Medicine, Tokyo Medical and Dental University
  • Sasano Tetsuo
    Department of Cardiovascular Medicine, Tokyo Medical and Dental University
  • Kakuta Tsunekazu
    Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital

説明

<p>Background: This study investigated the prognostic value of cardiovascular magnetic resonance (CMR)-derived global coronary flow reserve (G-CFR) in addition to cardiopulmonary exercise testing (CPET) variables in patients with acute myocardial infarction (AMI).</p><p>Methods and Results: We investigated 127 patients with AMI who underwent primary or urgent percutaneous coronary intervention (PCI) and post-intervention CMR and CPET. The incidence of major cardiac and cerebrovascular events (MACCE), defined as all-cause death, recurrent non-fatal myocardial infarction, re-hospitalization due to congestive heart failure, and stroke, was evaluated (median follow-up, 2.8 years). Patients with MACCE (n=14) had lower ejection fraction (EF) (50 [43–59] vs. 58 [51–63]%; P=0.014), lower G-CFR (1.74 [1.19–2.20] vs. 2.40 [1.61–3.66]; P=0.008), and lower peak oxygen consumption (V̇O2) (15.16±2.64 vs. 17.19±3.70 mL/kg/min; P=0.049) than patients without MACCE. G-CFR<2.33 and peak V̇O2<15.65 mL/kg/min (cut-off values derived from receiver operating characteristic curve analyses) were significantly associated with the incidence of MACCE (log-rank test, P=0.01). The combination of low G-CFR and low peak V̇O2improved risk discrimination for MACCE when added to the reference clinical model including age, male sex, post-PCI peak creatine kinase, EF, and left anterior descending artery culprit lesion.</p><p>Conclusions: G-CFR and peak V̇O2showed incremental prognostic information compared with the reference model using historically important clinical risk factors, indicating that this approach may help identify high-risk patients who suffer subsequent adverse events.</p>

収録刊行物

  • Circulation Reports

    Circulation Reports 6 (7), 255-262, 2024-07-10

    一般社団法人 日本循環器学会

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