ST-segment elevation myocardial infarction (STEMI) is associated with a systemic and local inflammatory response with edema. However, their role at the tissue level is poorly characterized. This study aims to characterize T2 values of the noninfarcted myocardium (NIM) and surrounding tissue and to investigate prognostic relevance of higher NIM T2 values after STEMI. A total of 171 consecutive patients with STEMI without prior cardiovascular events who underwent cardiac magnetic resonance after primary percutaneous coronary intervention were analyzed in terms of standard infarct characteristics. Edema of the NIM, liver, spleen, and pectoralis muscle was assessed based on T2 mapping. Follow-up was available for 130 patients. The primary endpoint was major adverse cardiac events (MACE), defined as cardiovascular death, myocardial infarction, unplanned coronary revascularization or rehospitalization for heart failure. The median time from primary percutaneous coronary intervention to cardiac magnetic resonance was 3 days (IQR: 2-5 days). Higher (above the median value of 45 ms) T2 values in the NIM area were associated with larger infarct size, microvascular obstruction, and left ventricular dysfunction and did not correlate with C-reactive protein, white blood cells, or T2 values of the pectoralis muscle, liver, and spleen. At a median follow-up of 17 months, patients with higher (>45 ms) NIM T2 values had increased risk of MACE ( < 0.001) compared with subjects with NIM T2 values ≤45 ms, mainly caused by a higher rate of myocardial reinfarction (26.3% vs 1.4%; < 0.001). At multivariable analysis, higher NIM T2 values independently predicted MACE (HR: 2.824 [95% CI: 1.254-6.361]; = 0.012). Higher NIM T2 values after STEMI are independently associated with worse cardiovascular outcomes, mainly because of higher risk of myocardial infarction.

中文翻译：

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STEMI 后 T2 标测评估非梗塞心肌及周围组织的急性反应

ST 段抬高型心肌梗死 (STEMI) 与全身和局部水肿炎症反应相关。然而，它们在组织水平上的作用尚不清楚。本研究旨在表征非梗塞心肌 (NIM) 和周围组织的 T2 值，并研究 STEMI 后较高 NIM T2 值的预后相关性。对 171 例既往无心血管事件的连续 STEMI 患者在初次经皮冠状动脉介入治疗后接受心脏磁共振检查的标准梗死特征进行了分析。根据 T2 映射评估 NIM、肝脏、脾脏和胸肌的水肿。对 130 名患者进行了随访。主要终点是主要不良心脏事件（MACE），定义为心血管死亡、心肌梗塞、计划外冠状动脉血运重建或心力衰竭再住院。从初次经皮冠状动脉介入治疗到心脏磁共振的中位时间为 3 天（IQR：2-5 天）。 NIM 区域较高（高于中值 45 ms）的 T2 值与较大的梗塞面积、微血管阻塞和左心室功能障碍相关，但与 C 反应蛋白、白细胞或胸肌的 T2 值无关肌肉、肝脏和脾脏。中位随访 17 个月时，与 NIM T2 值≤45 ms 的受试者相比，NIM T2 值较高（>45 ms）的患者发生 MACE 的风险增加（< 0.001），这主要是由于心肌再梗塞发生率较高（26.3% 与 1.4%；< 0.001）。在多变量分析中，较高的 NIM T2 值独立预测 MACE（HR：2.824 [95% CI：1.254-6.361]；= 0.012）。 STEMI 后较高的 NIM T2 值与较差的心血管结局独立相关，主要是因为心肌梗死的风险较高。