Detection and characteristics of microvascular obstruction in reperfused acute myocardial infarction using an optimized protocol for contrast-enhanced cardiovascular magnetic resonance imaging

Several cardiovascular magnetic resonance imaging (CMR) techniques are used to detect microvascular obstruction (MVO) after acute myocardial infarction (AMI). To determine the prevalence of MVO and gain more insight into the dynamic changes in appearance of MVO, we studied 84 consecutive patients with a reperfused AMI on average 5 and 104 days after admission, using an optimised single breath-hold 3D inversion recovery gradient echo pulse sequence (IR-GRE) protocol. Early MVO (2 min post-contrast) was detected in 53 patients (63%) and late MVO (10 min post-contrast) in 45 patients (54%; p = 0.008). The extent of MVO decreased from early to late imaging (4.3 ± 3.2% vs. 1.8 ± 1.8%, p < 0.001) and showed a heterogeneous pattern. At baseline, patients without MVO (early and late) had a higher left ventricular ejection fraction (LVEF) than patients with persistent late MVO (56 ± 7% vs. 48 ± 7%, p < 0.001) and LVEF was intermediate in patients with early MVO but late MVO disappearance (54 ± 6%). During follow-up, LVEF improved in all three subgroups but remained intermediate in patients with late MVO disappearance. This optimised single breath-hold 3D IR-GRE technique for imaging MVO early and late after contrast administration is fast, accurate and allows detection of patients with intermediate remodelling at follow-up

Body mass index growth trajectories associated with the different parameters of the metabolic syndrome at adulthood

BACKGROUND: Growth trajectories have shown to be related to obesity and metabolic risks in later life, however body mass index (BMI) trajectories according to the presence or absence of metabolic syndrome (MS) and its parameters in adulthood are scarce in literature. OBJECTIVES: To investigate BMI trajectories during childhood in relation to MS and its parameters in adult age. METHODS: A total of 1919 subjects (43.4% male, 20-60 y) participated in this retrospective cohort study. Height, weight, waist circumference (WC), blood glucose, high-density lipoprotein cholesterol, triglycerides and blood pressure were measured at adulthood. Childhood weight and height were collected retrospectively from health booklets. Differences between BMI growth curves of subjects with and without MS were assessed using mixed models for correlated data. RESULTS: BMI trajectories differed according to the presence or not of MS at adulthood, from the age of 4 years forward (all P 94 cm (men) / 80 cm (women) compared to lower WC, at all ages (all P<0.05). CONCLUSIONS: BMI growth curves differ according to the presence or not of MS at adulthood, but differences only appeared after the age of 4 years. Changes vary according to the MS parameters considered. Deviation of the MS-associated BMI curve from normal pattern could correspond to alteration in body composition. These differences in BMI trajectories during childhood support the theory of an early origin of the MS, justifying early prevention