Utility of CMR Markers of XXXX in Predicting LV Functional Recovery: Results from PROTECTION AMI CMR sub-study.

@entity1 @entity296 @entity3885 @entity1188 @entity1011 @entity583
BACKGROUND: Adverse left ventricular (LV) remodelling following acute @entity583 ( @entity583 ) has prognostic importance. We aimed to predict 90-day left ventricular (LV) function following acute @entity583 using variables from clinical presentation, biomarkers, and cardiovascular magnetic resonance imaging (CMR). METHODS: Consecutive @entity1 undergoing primary percutaneous coronary intervention for anterior @entity583 as part of the Selective Inhibition of Delta-protein Kinase C for the Reduction of @entity1188 Size in Acute @entity583 (PROTECTION-AMI) trial were enrolled into the CMR sub-study at selected sites. CMR was performed at baseline (days 3 to 5) and 90 days and used to evaluate @entity1188 size, myocardial salvage index, @entity1188 heterogeneity, @entity3885 and global LV function. Biochemical markers including @entity1011 kinase area under the curve (CK AUC), peak CK, peak CK-myocardial band (CK-MB) and AUC, and troponin I were collected at specific time-points. RESULTS: Ninety-six @entity1 were enrolled in the CMR sub study and 85 completed the 90-day follow-up, across 24 centres worldwide. LV ejection fraction (EF) was 56% (46-63%) at baseline and 60% (49-67%) at 90 days (p<0.001). @entity1188 size had moderate inverse correlation with 90-day EF (Spearman's rho=-0.7, p < 0.001) and had the strongest correlation when compared to myocardial salvage index (Spearman's rho=0.5, p=0.001), @entity1188 heterogeneity (Spearman's rho=-0.4, p=0.02 or @entity3885 (Spearman's rho=-0.4, p<0.001). All biochemical markers had similar moderate relationship to LVEF at 90 days (Spearman's rho -0.6 to -0.8, p=0.001). In a multivariable model, only baseline LVEF, CMR @entity1188 size and @entity1188 heterogeneity independently predicted 90-day LVEF. CONCLUSION: This study reports findings of a combined CMR protocol (including @entity296 imaging) in a multi-centre, multi-vendor setting. We found @entity1188 size, @entity1188 heterogeneity and myocardial salvage index correlated favourably with 90-day LVEF, however only the former two were independently predictive.
