Magnetic Resonance Imaging In Acute ST-Elevation Myocardial Infarction

Study Overview
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Brief Summary
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Cardiovascular magnetic resonance imaging enables comprehensive assessment of cardiovascular function, morphology and pathology. The investigators aim to evaluate the nature and clinical significance of magnetic resonance imaging parameters in patients presenting with first acute ST-elevation myocardial infarction.

Official Title
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Clinical Relevance of Magnetic Resonance Imaging in Acute ST-Elevation Myocardial Infarction

Conditions
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Acute ST-Elevation Myocardial Infarction

Intervention / Treatment
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* Diagnostic Test: Cardiovascular Magnetic Resonance Imaging


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: First ST-elevation myocardial infarction according to the European Society of Cardiology/American College of Cardiology committee criteria Primary percutaneous coronary intervention within 24 hours after symptom onset Exclusion criteria: Age < 18 years Any history of a previous myocardial infarction or coronary intervention Clinically unstable patients (Killip class >2) Renal failure (estimated glomerular filtration rate < 30 ml/min/1.73 m2) Contraindications to cardiac magnetic resonance imaging (pacemaker, cerebral aneurysm clip, orbital foreign body, known or suggested contrast allergy to gadolinium, claustrophobia) Inability to provide informed consent

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| ST-Elevation Myocardial Infarction<br>Patients with acute ST-elevation myocardial infarction treated with primary percutaneous coronary intervention | Diagnostic Test: Cardiovascular Magnetic Resonance Imaging<br>* Cardiovascular magnetic resonance imaging will be performed within the first week after ST-elevation myocardial infarction and in a defined subgroup 4 months, 12 months and 10 years thereafter.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Occurence of major adverse cardiovascular events |  | 1 - 5 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Infarct size assessment (% of left ventricular myocardial mass) |  | baseline, 4 months and 12 months | 
| Assessment of infarct transmurality grade (%) with late gadolinium enhancement imaging |  | baseline, 4 months and 12 months | 
| Occurence and area of microvascular obstruction |  | baseline | 
| Intramyocardial haemorrhage assessed by T2* imaging |  | baseline, 4 months and 12 months | 
| Tissue characterisation by T1, T2 and T2* Mapping |  | baseline, 4 months and 12 months | 
| Myocardial deformation by strain analysis |  | baseline, 4 months and 12 months | 
| Chamber volumes by cine imaging |  | baseline, 4 months and 12 months | 
| Cardiac function by cine imaging |  | baseline, 4 months and 12 months | 
| Stroke volumes by phase contrast imaging |  | baseline, 4 months and 12 months | 
| Aortic pulse wave velocity and distensibility by phase contrast imaging |  | baseline, 4 months and 12 months | 
| Aortic pulse wave distensibility by phase contrast imaging |  | baseline, 4 months and 12 months | 
| Quality of life and invalidity assessment (Global Physical Activity Questionnaire) |  | 1 - 5 years | 
| Biomarker release during the acute and subacute phase | biomarker concentrations of hemodynamic stress (n-terminal pro-B-type natriuretic peptide), neurohumoral markers (i.e. neprilysin ng/ml), inflammatory markers (i.e. procalcitonin µg/l) and markers of myocardial injury (i.e. high sensitivity cardiac troponin T ng/l) | baseline, 4 months and 12 months | 
| Parameters of cardiac function by transthoracic echocardiography |  | baseline, 4 months and 12 months | 
| Plaque volume by 3D ultrasound |  | baseline, 12 months | 
| Cardiac autonomic function | Deceleration capacity of heart rate | baseline, 4 months and 12 months | 
| Cardiac autonomic function | Heart rate variability | baseline, 4 months and 12 months | 
| Cardiac autonomic function | Periodic repolarization dynamics | baseline, 4 months and 12 months | 
| Cardiac autonomic function | Baroreflex sensitivity | baseline, 4 months and 12 months | 
| Cardiac autonomic function | Skin sympathetic nerve activity | baseline, 4 months and 12 months |