TY - JOUR JO - EuroIntervention TI - Thermodilution-derived temperature recovery time: a novel predictor of microvascular reperfusion and prognosis after myocardial infarction AB - <p><strong>Background:</strong> Novel parameters that detect failed microvascular reperfusion might identify better the patients likely to benefit from adjunctive treatments during primary percutaneous coronary intervention (PCI).</p> <p><strong>Aims:</strong> The aim of this study was to test the hypothesis that a novel invasive parameter, the thermodilution-derived temperature recovery time (TRT), would be associated with microvascular obstruction (MVO) and prognosis.</p> <p><strong>Methods:</strong> TRT was derived and validated in two independent ST-elevation myocardial infarction populations and was measured immediately post PCI. TRT was defined as the duration (seconds) from the nadir of the hyperaemic thermodilution curve to 20% from baseline body temperature. MVO extent (% left ventricular mass) was assessed by cardiovascular magnetic resonance imaging at 2-7 days.</p> <p><strong>Results:</strong> In the retrospective derivation cohort (n=271, mean age 60&plusmn;12 years, 72% male), higher TRT was associated with more MVO (coefficient: 4.09 [95% CI: 2.70-5.48], p&lt;0.001), independently of IMR &gt;32, CFR &le;2, hyperaemic Tmn &gt;median, thermodilution waveform, age and ischaemic time. At five years, higher TRT was multivariably associated with all-cause death/heart failure hospitalisation (OR 4.14 [95% CI: 2.08-8.25], p&lt;0.001) and major adverse cardiac events (OR 4.05 [95% CI: 2.00-8.21], p&lt;0.001). In the validation population (n=144, mean age 59&plusmn;11 years, 80% male), the findings were confirmed prospectively.</p> <p><strong>Conclusions:</strong> TRT represents a novel diagnostic advance for predicting MVO and prognosis. ClinicalTrials.gov Identifiers: NCT02072850 &amp; NCT02257294</p> <p><img src="https://files.eurointervention.com/issues/EIJ189/039_EIJ-D-19-00904_Maznyczka_189/image/visual_summary/00_Maznyczka_189.png" alt="" /></p> <p class="VisualSummary"><strong>Visual summary.</strong> Thermodilution-derived temperature recovery time (TRT): a novel predictor of microvascular reperfusion &amp; prognosis after STEMI. CMR: cardiovascular magnetic resonance; MACE: major adverse cardiac events; MVO: microvascular obstruction; PCI: percutaneous coronary intervention; STEMI: ST-segment elevation myocardial infarction</p> AU - Maznyczka M. Annette AU - Carrick David AU - Oldroyd G. Keith AU - James-Rae Greg AU - McCartney Peter AU - Greenwood P. John AU - Good Richard AU - McEntegart B. Margaret AU - Eteiba Hany AU - Lindsay M. Mitchell AU - Cotton M. James AU - Petrie C. Mark AU - Berry Colin VL - 17 IS - 3 Y1 - 25/06/2021 Y1 - 2021 DOI - 10.4244/EIJ-D-19-00904 SP - 220 EP - 228 KW - stemi KW - mri PB - Europa Digital & Publishing SE - Coronary interventions UR - https://eurointervention.pcronline.com/article/thermodilution-derived-temperature-recovery-time-a-novel-predictor-of-microvascular-reperfusion-and-prognosis-after-myocardial-infarction SN - 1774-024X ER -