Delayed enhancement on multidetector computed tomography predicts regional functional improvement and cardiovascular events after reperfused acute myocardial infarction

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K23936
• Research Category: Grant-in-Aid for Research Activity Start-up
• Allocation Type: Multi-year Fund
• Review Section: 0902:General internal medicine and related fields
• Research Institution: University of Tsukuba
• Principal Investigator: Watabe Hiroaki 筑波大学, 附属病院, 病院講師 (80795302)
• Project Period (FY): 2019-08-30 – 2022-03-31
• Keywords: 急性心筋梗塞 / 遅延造影CT / 心筋バイアビリティ / 心血管合併症 / 急性腎障害 / PCI

Outline of Final Research Achievements

We studied the evaluation of myocardial damage by delayed enhancement multidetector computed tomography (DE-MDCT) without iodine re-injection performed immediately following successful percutaneous coronary intervention in patients with acute myocardial infarction (AMI). In this study, we showed that the regional extent of delayed enhancement as measured by MDCT enables the prediction of the functional improvement of the stunned myocardium in patients with AMI. Moreover, we showed heterogenesous enhancement (HE) detected by DE-MDCT was associated with the occurrence of acute kidney injury and long-term cardiovascular events in AMI patients.

Free Research Field

循環器

Academic Significance and Societal Importance of the Research Achievements

この急性心筋梗塞後のMDCT遅延造影検査は、①MDCT撮像時に追加の造影剤は投与せずに遅延造影を得ることができること。②撮像時間が数分程度であるため、容易で安全かつ短時間で検査を行うことができること。③急性心筋梗塞に対するPCIの直後に遅延造影像を得ることができるため、より早期に患者のリスク評価を行うことができること、などの利点が挙げられる。日本は欧米諸国と比較しても、病院のCT保有率が高く、この検査手法が心筋梗塞後の検査として普及すれば、より多くの施設でPCIの直後に心筋梗塞後のリスク評価を行うことが可能となり、ひいては心筋梗塞患者の予後を改善させる可能性があると考えられる。