Early Comprehensive Cardiovascular Magnetic Resonance Imaging in Patients With Myocardial Infarction With Nonobstructive Coronary Arteries

作者：Peder Sörensson, Christina Ekenbäck, Magnus Lundin, Stefan Agewall, Elin Bacsovics Brolin, Kenneth Caidahl, Kerstin Cederlund, Olov Collste, Maria Daniel, Jens Jensen, Shams Y‐Hassan, Loghman Henareh, Claes Hofman‐Bang, Patrik Lyngå, Eva Maret, Nondita Sarkar, Jonas Spaak, Oscar Winnberg, Martin Ugander, Per Tornvall · 发表于：JACC. Cardiovascular imaging · 年份：2021 · DOI：10.1016/j.jcmg.2021.02.021 · 被引用次数：95 · 研究领域：Cardiac Imaging and Diagnostics、Acute Myocardial Infarction Research、Takotsubo Cardiomyopathy and Associated Phenomena

OBJECTIVES: The objective of the SMINC-2 (Stockholm Myocardial Infarction With Normal Coronaries 2) study was to determine if more than 70% of patients with myocardial infarction with nonobstructed coronary arteries (MINOCA), investigated early with comprehensive cardiovascular magnetic resonance (CMR), could receive a diagnosis entirely by imaging. BACKGROUND: The etiology of MINOCA is heterogeneous, including coronary, cardiac, and noncardiac causes. Patients with MINOCA, therefore, represent a diagnostic challenge where CMR is increasingly used. METHODS: and extracellular volume mapping early after hospital admission, compared to 150 patients with MINOCA imaged using 1.5-T CMR without mapping techniques from the SMINC-1 study as historic controls. RESULTS: CMR was performed at a median of 3 (SMINC-2) versus 12 (SMINC-1) days after hospital admission. In total, 77% of patients received a diagnosis with CMR imaging in the SMINC-2 study compared to 47% in the SMINC-1 study (p < 0.001). Compared to SMINC-1, CMR in SMINC-2 detected higher proportions of myocarditis (17% vs. 7%; p = 0.01) and takotsubo syndrome (35% vs. 19%; p = 0.002) but similar proportions of myocardial infarction (22% vs. 19%; p = 0.56) and other cardiomyopathies (3% vs. 2%; p = 0.46). CONCLUSIONS: The results of the SMINC-2 study show that 77% of all patients with MINOCA received a diagnosis when imaged early with CMR, including advanced tissue characterization, which was a considerable improvement in compa...