ArticleCurrent medical imaging2025
A Novel and Simplified MSI Approach to Predicting the Long-term Cardiac Function of STEMI.
Article in Current medical imaging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThe Myocardial Salvage Index (MSI) is a valuable indicator in ST-segment Elevation Myocardial Infarction (STEMI) treated with Percutaneous Coronary Intervention (PCI), yet challenges exist in its acquisition. This study aims to calculate MSI using Coronary Angiography (CAG) and myocardial perfusion imaging, and further investigate its correlation with long-term cardiac function.
methodsIn 203 STEMI, the myocardium at risk was measured through CAG using the Bypass Angioplasty Revascularization Investigation Myocardial Jeopardy Index (BARI) score. The infarcted myocardium was measured by the Total Perfusion Deficit (TPD) obtained in Myocardial Perfusion Imaging (MPI) after PCI. MSI was computed as (BARI score-TPD)/BARI score. Long-term cardiac function was assessed via echocardiography.
resultsThe MSI is notably associated with the long-term cardiac function [EF: Beta = 16 (13, 20), P < 0.00; LVD: Beta = -7.3 (-9.3, -5.3), P < 0.001]. TIMI flow grades 2-3 demonstrate a superior MSI compared to grades 0-1 [0.78 (0.32) vs. 0.61 (0.38), P = 0.002]. TIMI flow grades have an impact on MSI [Beta = 0.08 (0.04, 0.13), P < 0.001]. Compared to patients with a Killip grade of < 2, those with a grade ≥ 2 exhibit a lower MSI [0.69 (0.35) vs. 0.48 (0.42), p = 0.005]. The Killip classification has an impact on MSI [Beta = -0.12(-0.19, -0.04), P = 0.003]. DISCUSSION: The study indicates the pivotal role of MSI in predicting long-term cardiac function in STEMI, compares the advantages and limitations of SPECT, CMR, and hybrid SPECT/CAG methods, analyzes the impact of residual blood flow and acute heart failure on MSI, and highlights current technological challenges and future research directions.
conclusionCAG combining MPI after PCI can be used to obtain MSI. MSI is linked to long-term cardiac function. The amount of antegrade flow before PCI and the initial cardiac function upon admission significantly influence MSI.
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