ST-Segment Resolution as a Marker for Myocardial Scar in ST-Segment Elevation Myocardial Infarction

Study Overview
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Brief Summary
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Clinical studies found that poor ST-segment resolution (STR) in electrocardiogram (ECG) occurred in major adverse cardiovascular events (MACE), arrhythmia and heart failure was significantly higher . In clinical work, in patients have poor ST-segment decline, the investigators found by CMR-LGE the corresponding myocardium become thinner and other signs of myocardial scar. The investigators aimed to establish whether poor ST-segment resolution in ECG, as well as CMR-LGE, could detect the presence of myocardial scar in early STEMI patients. In order to provide convenient, cheap and widely used test method for patients who cannot tolerate CMR-LGE. 42 STEMI patients with single-branch coronary artery stenosis or occlusion were enrolled. ST-segment elevations were measured on the baseline and 24 hours after PCI. The study population was divided into two groups by late gadolinium enhanced cardiac magnetic resonance (LGE- CMR), with transmural myocardial scar (>75%) or non-transmural myocardial scar (<75%).

Official Title
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The First Affiliated Hospital of Chongqing Medical University.

Conditions
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Cardiovascular Diseases

Intervention / Treatment
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* Diagnostic Test: ST-segment resolution <40.15%


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Single-branch coronary artery stenosis or occlusion Restoration of coronary perfusion to TIMI flow grade 3 after PCI Exclusion Criteria: A prior history of the acute coronary syndrome Coronary revascularization Severe chronic kidney disease Intracardiac pacing leads or other implants precluding CMR-LGE Hemodynamic instability Known claustrophobia

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 80 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-segment resolution <40.15%<br>ST-segment resolution <40.15% | Diagnostic Test: ST-segment resolution <40.15%<br>* Forty-two STEMI patients with single-branch coronary artery stenosis or occlusion were enrolled. ST-segment elevations were measured at emergency admission and at 24 h after PCI. Late gadolinium-enhanced cardiac magnetic resonance imaging (CMR-LGE) was performed 7 days after PCI to evaluate myocardial scars.<br>|
| ST-segment resolution >40.15%<br>ST-segment resolution >40.15% | Diagnostic Test: ST-segment resolution <40.15%<br>* Forty-two STEMI patients with single-branch coronary artery stenosis or occlusion were enrolled. ST-segment elevations were measured at emergency admission and at 24 h after PCI. Late gadolinium-enhanced cardiac magnetic resonance imaging (CMR-LGE) was performed 7 days after PCI to evaluate myocardial scars.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| ST-segment resolution<40.15% | CMR-LGE was performed to evaluate myocardial scars. | 1) Emergency admission: ST-segment elevations were measured. 2) 24 hours after PCI: ST-segment elevations were measured. 3) 7 days after PCI: CMR-LGE was performed. | 
| ST-segment resolution>40.15% | CMR-LGE was performed to evaluate myocardial scars. | 1) Emergency admission: ST-segment elevations were measured. 2) 24 hours after PCI: ST-segment elevations were measured. 3) 7 days after PCI: CMR-LGE was performed. |