BACKGROUND Periprocedural myocardial injury (pMI) is a common complication of elective percutaneous coronary intervention (PCI) that reduces some of the beneficial effects of coronary revascularization and impacts the risk of cardiovascular events. We developed a 3-dimensional volumetric cardiovascular magnetic resonance (CMR) method to evaluate coronary high intensity plaques and investigated their association with pMI after elective PCI. METHODS Between October 2012 and October 2016, 141 patients with stable coronary artery disease underwent T1-weighted CMR imaging before PCI. A conventional 2-dimensional CMR plaque-to-myocardial signal intensity ratio (2D-PMR) and the newly developed 3-dimensional integral of PMR (3Di-PMR) were measured. 3Di-PMR was determined as the sum of PMRs above a threshold of > 1.0 for voxels in a target plaque. pMI was defined as high-sensitivity cardiac troponin T > 0.07 ng/mL. RESULTS pMI following PCI was observed in 46 patients (33%). 3Di-PMR was significantly higher in patients with pMI than those without pMI. The optimal 3Di-PMR cutoff value for predicting pMI was 51 PMR*mm3 and the area under the receiver operating characteristic curve (0.753) was significantly greater than that for 2D-PMR (0.683, P = 0.015). 3Di-PMR was positively correlated with lipid volume (r = 0.449, P < 0.001) based on intravascular ultrasound. Stepwise multivariable analysis showed that 3Di-PMR ≥ 51 PMR*mm3 and the presence of a side branch at the PCI target lesion site were significant predictors of pMI (odds ratio [OR], 11.9; 95% confidence interval [CI], 4.6-30.4, P < 0.001; and OR, 4.14; 95% CI, 1.6-11.1, P = 0.005, respectively). CONCLUSIONS 3Di-PMR coronary assessment facilitates risk stratification for pMI after elective PCI. TRIAL REGISTRATION retrospectively registered.

中文翻译：

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T1加权心血管磁共振成像对冠状动脉高强度斑块进行三维评估，以预测选择性经皮冠状动脉介入治疗后的围手术期心肌损伤。

背景技术围手术期心肌损伤（pMI）是选择性经皮冠状动脉介入治疗（PCI）的常见并发症，其降低了冠状动脉血运重建的一些有益作用并影响了心血管事件的风险。我们开发了三维立体心血管磁共振（CMR）方法来评估冠状动脉高强度斑块，并研究了择期PCI后它们与pMI的关系。方法2012年10月至2016年10月，对141例稳定的冠状动脉疾病患者进行PCI前的T1加权CMR成像。测量了常规的二维CMR斑块与心肌的信号强度比（2D-PMR）和新开发的PMR的3维积分（3Di-PMR）。3Di-PMR被确定为目标斑块中体素的阈值> 1.0时PMR的总和。pMI被定义为高敏感性心肌肌钙蛋白T> 0.07 ng / mL。结果46例患者中观察到PCI后的pMI（33％）。pMI患者的3Di-PMR明显高于非pMI患者。预测pMI的最佳3Di-PMR截止值为51 PMR * mm3，接收器工作特性曲线下的面积（0.753）明显大于2D-PMR的面积（0.683，P = 0.015）。基于血管内超声，3Di-PMR与血脂量呈正相关（r = 0.449，P <0.001）。逐步多变量分析表明，3Di-PMR≥51 PMR * mm3和PCI目标病变部位存在侧支是pMI的重要预测指标（几率[OR]为11.9； 95％置信区间[CI]为4.6- 30.4，P <0.001；或OR，4.14； 95％CI，1.6-11.1，P = 0.005）。结论3Di-PMR冠状动脉评估有助于选择性PCI后pMI的危险分层。审判注册进行追溯注册。