Poster électronique

Obstruction microvasculaire en IRM de l'infarctus myocardique en phase aiguë : corrélation à la troponinémie
J. Jehl, C. Daragon, A. Comte, N. Meneveau, F. Schiele, B. Kastler - Besançon - France
Congrès 2010
Résumé
Objectifs
Rechercher, à la phase aiguë de l'infarctus du myocarde (IDM), une corrélation entre la troponinémie I et l'étendue de l’obstruction microvasculaire (no reflow) détectée en IRM. Définir un seuil de troponine prédictif de la présence de no reflow.
Matériels et méthodes
Inclusion prospective de 51 patients ayant présenté un IDM inaugural. La taille de l'IDM et l'étendue du no reflow ont étéévaluées par IRM 3 Tesla à 5,7+/-2,7 jours grâce à des séquences de rehaussement à 3 puis 15 minutes après injection de gadolinium. La taille du noreflow à 3 minutes (MO) et 15 minutes (PMO) a été corrélée aux dosages de troponine à 6, 12, 24, 48, 72 heures après admission.
Résultats
L'étendue du MO est significativement corrélée au pic (p < 0,013), à l'aire sous la courbe (p < 0,005) et aux dosages itératifs de troponine (p < 0,05) et ceci plus fidèlement que le PMO. Après analyse des courbes ROC, un seuil de troponine > 89 ng/ml à la sixième heure était le plus prédictif de la présence de MO (sensibilité de 63 %, spécificité de 88,2 %).
Conclusion
Le no reflow mesuréà 3 minutes est corréléà la troponinémie I de façon plus fidèle que le no reflow mesuréà 15 minutes.
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2018-01-01 19.55 :
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2010-10-23 13.04 :
cotty

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