Abstracts i913

Poster Session

P1437

Integrated ST segment elevation score as a new predictor of the myocardial scar ex-
tent determined with LGE-CMR at 1-month follow-up after STEMI
Mester A.1; Benedek T.2; Opincariu D.1; Benedek A.1; Ratiu M.3; Hodas R.1; Cernica D.1; Kovacs I.2; Rat N.3; Chitu M.3; Benedek I.2

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1County Emergency Hospital of Targu Mures, Targu Mures, Romania
2University
of Medicine and Pharmacy, Targu-Mures, Romania
3Cardiomed Center of Advanced Research in Multimodality Cardiac Imaging, Targu-Mures, Romania

Funding Acknowledgements: Funded by the research grant PlaqueImage, contract number 26/01.09.2016, SMIS code 103544, by the
European Union and the Government of Romania
Background: The inflammatory response in the acute phase of a myocardial infarction, as well as in later phases contributes to the healing
process of the infarcted myocardium and the left ventricular remodeling. Restoration and improvement of LV function highly depends on the
magnitude of scar formation. Late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) imaging has been validated for an ac-
curate determination of the myocardial scar size and transmurality. The recovery of ST segment elevation is a liable marker of vessel paten-
cy following PCI.
Purpose: The aim of the study was to validate a new integrated score of ST segment elevation score (ISSTE) as a new predictor of the
myocardial scar tissue size, in relation with increased inflammatory biomarkers, with the extent of myocardial fibrosis at one month, as-
sessed with LGE-CMR, after STEMI.
Methods: We included 65 patients with STEMI who underwent urgent revascularization with PCI in the first 12 hours from the onset of
symptoms. The ISSTE was determined by summing the ST segment elevation in all registered ECG leads at presentation (ISSTE-1) and at
2 hours (ISSTE-2) after primary PCI. Blood samples were also collected at baseline and day-5 for determination of serum hs-CRP levels. At
1-month follow-up all patients under LGE-CMR (1.5T scanner) for evaluation of the myocardial scar extent (volume, percentage, transmurali-
ty).
Results: ISSTE-2 was significantly correlated with day-5 hs-CRP serum levels (r = 0.546, 95%CI: 0.030-0.832, p = 0.037), although no sig-
nificant correlations were noted with baseline hs-CRP levels (r= 0.238, p = 0.407). There were no significant correlations between ISSTE-1
score and the myocardial scar percentage (r = 0.241, p = 0.11) or high transmurality volume (r = 0.194, p = 0.21), while ISSTE-2 significantly
correlated with myocardial scar mass (r = 0.406, 95%CI: 0.107-0.637 p = 0.007) and high transmurality volume (r = 0.344, 95%CI:
0.0320-0.596, p = 0.0273). The restoration of the ST segment, reflected by the difference between ISSTE-1 and ISSTE -2 is correlated with
the infarct size mass (r = 0.336, 95%CI: 0.0307 -0.584, p = 0.027).
Conclusion: The magnitude of ST segment elevation determined at 2 hours after PCI was associated with the inflammatory response at
day 5 after STEMI and it may serve as a predictor for the extent of the myocardial scar tissue determined with LGE-CMR at 1 month follow-
ing STEMI. The ISSTE-1 score calculated at presentation does not reflect extent of the affected myocardial tissue following PCI.