TY - JOUR
T1 - Assessment of infarct characteristics and left ventricular function on serial CMR in STEMI patients treated with post-PCI sonothrombolysis
T2 - post-hoc analysis of two randomized controlled trials
AU - Kadi, Soufiane El
AU - Li, Shouqiang
AU - Hovseth, Chad
AU - Hopman, Luuk H. G. A.
AU - van de Veerdonk, Mariëlle C.
AU - Verouden, Niels J. W.
AU - Xie, Feng
AU - van Rossum, Albert C.
AU - Kamp, Otto
AU - Porter, Thomas R.
N1 - Publisher Copyright:
© 2025 The Author(s)
PY - 2025/10/1
Y1 - 2025/10/1
N2 - Background: Several randomized clinical trials have studied sonothrombolysis as adjunctive treatment in ST-elevation myocardial infarction (STEMI) patients to reduce infarct size (IS) and preserve left ventricular (LV) function. This study aims to assess infarct characteristics and LV function in STEMI patients treated with sonothrombolysis following primary percutaneous coronary intervention (PCI) on cardiovascular magnetic resonance (CMR) imaging. Methods: Fifty-two STEMI patients were prospectively randomized to receive sonothrombolysis immediately following PCI and underwent early (within seven days after STEMI) and follow-up (6–8 weeks) CMR imaging. IS and distribution pattern, microvascular obstruction, intramyocardial hemorrhage and T1/T2-mapping of infarct and remote zone, as well as LV global longitudinal strain (GLS) and LV ejection fraction (LVEF) were assessed on early CMR. IS and LV systolic function were also assessed on follow-up CMR. Results: Mean age was 58 years, and culprit artery was predominately left anterior descending artery in both groups (92 % and 93 %, respectively). Although there were no differences in IS at baseline and follow-up, infarct pattern was significantly different between the groups on early CMR (patchy LGE pattern in 46 % of the sonothrombolysis vs. 19 % control group, p = 0.04). Significant LVEF improvement (ΔLVEF:7.2 ± 5.4 %, p < 0.01 vs ΔLVEF: 0.9 ± 7.2 %, p = 0.29) and GLS improvement (|ΔGLS|: 3.2 ± 3.2 %, p < 0.01 vs. |ΔGLS|:1.5 ± 4.2 %, p = 0.07) was observed in the sonothrombolysis group, but not in the control group. Conclusion: LV systolic function improvement at 6–8 weeks following STEMI was observed in patients treated with post-PCI sonothrombolysis independent of IS reduction. Further investigation into the effects of post-PCI sonothrombolysis on infarct zone viability is needed.
AB - Background: Several randomized clinical trials have studied sonothrombolysis as adjunctive treatment in ST-elevation myocardial infarction (STEMI) patients to reduce infarct size (IS) and preserve left ventricular (LV) function. This study aims to assess infarct characteristics and LV function in STEMI patients treated with sonothrombolysis following primary percutaneous coronary intervention (PCI) on cardiovascular magnetic resonance (CMR) imaging. Methods: Fifty-two STEMI patients were prospectively randomized to receive sonothrombolysis immediately following PCI and underwent early (within seven days after STEMI) and follow-up (6–8 weeks) CMR imaging. IS and distribution pattern, microvascular obstruction, intramyocardial hemorrhage and T1/T2-mapping of infarct and remote zone, as well as LV global longitudinal strain (GLS) and LV ejection fraction (LVEF) were assessed on early CMR. IS and LV systolic function were also assessed on follow-up CMR. Results: Mean age was 58 years, and culprit artery was predominately left anterior descending artery in both groups (92 % and 93 %, respectively). Although there were no differences in IS at baseline and follow-up, infarct pattern was significantly different between the groups on early CMR (patchy LGE pattern in 46 % of the sonothrombolysis vs. 19 % control group, p = 0.04). Significant LVEF improvement (ΔLVEF:7.2 ± 5.4 %, p < 0.01 vs ΔLVEF: 0.9 ± 7.2 %, p = 0.29) and GLS improvement (|ΔGLS|: 3.2 ± 3.2 %, p < 0.01 vs. |ΔGLS|:1.5 ± 4.2 %, p = 0.07) was observed in the sonothrombolysis group, but not in the control group. Conclusion: LV systolic function improvement at 6–8 weeks following STEMI was observed in patients treated with post-PCI sonothrombolysis independent of IS reduction. Further investigation into the effects of post-PCI sonothrombolysis on infarct zone viability is needed.
KW - Cardiovascular magnetic resonance
KW - Infarct pattern
KW - STEMI
KW - Sonothrombolysis
KW - Systolic function
UR - https://www.scopus.com/pages/publications/105011147766
U2 - 10.1016/j.ijcha.2025.101757
DO - 10.1016/j.ijcha.2025.101757
M3 - Article
C2 - 40741300
SN - 2352-9067
VL - 60
JO - IJC Heart and Vasculature
JF - IJC Heart and Vasculature
M1 - 101757
ER -
