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. 2023 Apr;14(2):97-105.
doi: 10.14740/cr1468. Epub 2023 Apr 8.

Chest Pain in Acute Myocardial Infarction and Its Association With the Culprit Artery and Fibrotic Segment Identified by Cardiac Magnetic Resonance

Weverton Ferreira Leite  1 , Rui Manuel Dos Santos Povoa  1 , Adriano Mendes Caixeta  2 , Celso Amodeo  1 , Gilberto Szarf  3 , Maria Teresa Nogueira Bombig  1 , Maria Cristina Oliveira Izar  4 , Luciana Netto Gioia  5 , Wilma Noia Ribeiro  6 , Francisco Antonio Helfenstein Fonseca  4
Affiliations

Chest Pain in Acute Myocardial Infarction and Its Association With the Culprit Artery and Fibrotic Segment Identified by Cardiac Magnetic Resonance

Weverton Ferreira Leite et al. Cardiol Res. 2023 Apr.

Abstract

Background: It is still very controversial whether the characteristics of pain in the acute myocardial infarction could be related to the culprit coronary artery. There are no data about associations of pain with the ST-segment elevation myocardial infarction (STEMI) and left ventricular (LV) fibrotic segments.

Methods: Data from 328 participants who had STEMI and were included in the B and T Types of Lymphocytes Evaluation in Acute Myocardial Infarction (BATTLE-AMI) study were analyzed. The culprit artery was identified by coronary angiography and the injured myocardial segments by cardiac magnetic resonance. The statistical significance was established by P value < 0.05.

Results: A total of 223 patients (68%) were selected. Association was not observed between chest pain and the culprit artery (P = 0.237), as well as between pain irradiation and the culprit artery (P = 0.473). No significant difference was observed in the pain localization in relation to the segments in the short axis basal, mid, apical, and long axis, except for the mid inferior segment. The data were not considered clinically relevant because this association was observed in only one of 17 segments after multiple comparisons.

Conclusions: In patients with STEMI, no associations were observed between the location or irradiation of acute chest pain and/or adjacent areas and the culprit artery, or between pain and segmental myocardial fibrosis in the LV.

Keywords: Cardiac magnetic resonance imaging; Chest pain; Culprit coronary artery; Fibrosis; Myocardial infarction.

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Conflict of interest statement

The authors declare that they have no conflict of interests.

Figures

Figure 1
Figure 1
Distribution of causes of ineligibility for the study. STEMI: ST-segment elevation myocardial infarction; CMR: cardiac magnetic resonance; MINOCA: myocardial infarction with non-obstructive coronary arteries.
Figure 2
Figure 2
Acute retrosternal pain and culprit coronary artery for STEMI. Three patients (A, B and C) with the same retrosternal location of pain and different obstructed coronary arteries (arrows). STEMI: ST-segment elevation myocardial infarction.
See this image and copyright information in PMC

References

    1. Nicolau JC, Feitosa Filho GS, Petriz JL, Furtado RHM, Precoma DB, Lemke W, Lopes RD. et al. Brazilian society of cardiology guidelines on unstable angina and acute myocardial infarction without ST-segment elevation - 2021. Arq Bras Cardiol. 2021;117(1):181–264. doi: 10.36660/abc.20210180. - DOI - PMC - PubMed
    1. G. B. D. Mortality, Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385(9963):117–171. doi: 10.1016/S0140-6736(14)61682-2. - DOI - PMC - PubMed
    1. Macruz R, Toriano N, Carvalho VB, Arie S, Marrara JP, Tranchesi J, Pileggi F. et al. Dor cardiaca, valor de sua caracterizacao para a localizacao da obstrucao coronaria. Arq Bras Cardiol. 1973;26:525–549.
    1. Gulati M, Levy PD, Mukherjee D, Amsterdam E, Bhatt DL, Birtcher KK, Blankstein R. et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021;144(22):e368–e454. doi: 10.1161/CIR.0000000000001029. - DOI - PubMed
    1. Leite WF. Analise comparativa entre a proteina C-reativa de alta sensibilidade em veia periferica e seio coronario na angina estavel e instavel. [thesis]. Sao Paulo: Faculdade de Medicina. 2014. Cited on Sep 24, 2022. Available from: http://www.teses.usp.br/teses/disponiveis/5/5131/tde-26022015-152337.

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