Three-dimensional assessment of coronary high-intensity plaques with T1-weighted cardiovascular magnetic resonance imaging to predict periprocedural myocardial injury after elective percutaneous coronary intervention

Hayato Hosoda, Yasuhide Asaumi, Teruo Noguchi, Yoshiaki Morita, Yu Kataoka, Fumiyuki Otsuka, Kazuhiro Nakao, Masashi Fujino, Toshiyuki Nagai, Michikazu Nakai, Kunihiro Nishimura, Atsushi Kono, Yoshiaki Komori, Tomoya Hoshi, Akira Sato, Tomohiro Kawasaki, Chisato Izumi, Kengo Kusano, Tetsuya Fukuda, Satoshi Yasuda

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Background: Periprocedural myocardial injury (pMI) is a common complication of elective percutaneous coronary intervention (PCI) that reduces some of the beneficial effects of coronary revascularization and impacts the risk of cardiovascular events. We developed a 3-dimensional volumetric cardiovascular magnetic resonance (CMR) method to evaluate coronary high intensity plaques and investigated their association with pMI after elective PCI. Methods: Between October 2012 and October 2016, 141 patients with stable coronary artery disease underwent T1-weighted CMR imaging before PCI. A conventional 2-dimensional CMR plaque-to-myocardial signal intensity ratio (2D-PMR) and the newly developed 3-dimensional integral of PMR (3Di-PMR) were measured. 3Di-PMR was determined as the sum of PMRs above a threshold of > 1.0 for voxels in a target plaque. pMI was defined as high-sensitivity cardiac troponin T > 0.07 ng/mL. Results: pMI following PCI was observed in 46 patients (33%). 3Di-PMR was significantly higher in patients with pMI than those without pMI. The optimal 3Di-PMR cutoff value for predicting pMI was 51 PMR*mm3 and the area under the receiver operating characteristic curve (0.753) was significantly greater than that for 2D-PMR (0.683, P = 0.015). 3Di-PMR was positively correlated with lipid volume (r = 0.449, P < 0.001) based on intravascular ultrasound. Stepwise multivariable analysis showed that 3Di-PMR ≥ 51 PMR*mm3 and the presence of a side branch at the PCI target lesion site were significant predictors of pMI (odds ratio [OR], 11.9; 95% confidence interval [CI], 4.6-30.4, P < 0.001; and OR, 4.14; 95% CI, 1.6-11.1, P = 0.005, respectively). Conclusions: 3Di-PMR coronary assessment facilitates risk stratification for pMI after elective PCI. Trial registration: retrospectively registered.

Original languageEnglish
Article number5
JournalJournal of Cardiovascular Magnetic Resonance
Volume22
Issue number1
DOIs
Publication statusPublished - 2020 Jan 16
Externally publishedYes

Keywords

  • Coronary atherosclerosis
  • Magnetic resonance imaging
  • Percutaneous coronary intervention

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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