Myocardial Infarction
Conditions
Keywords
cardiac angiography, cardiac MRI
Brief summary
The purpose of this study is therefore to show that associated with cardiac angiography echocardiography, in myocardial seen late, would provide the information necessary for the decision revascularization, in a timely manner. This would allow the patient to avoid duplication of tests including risk related to coronary angiography (bleeding complications, stroke ...) and those related to the implantation of coronary stent (stent) without expected earnings in case of non-viability . This would also reduce the length of hospital stay and costs due to numerous reviews.
Detailed description
Percutaneous coronary intervention is not recommended in stable patients with late presentation myocardial infarction, and myocardial viability needs to be evaluated before the procedure. The aim of the study is to evaluate the sensibility and specificity of dual-energy CT for the evaluation of myocardial viability in comparison to cardiac MRI. The experimental procedure is limited to a second CT acquisition performed 10 minutes in dual energy mode. Sensitivity and Specificity of delayed enhancement \>50% of myocardial thickness provided by dual-energy CT will be evaluated in comparison to cardiac MRI.
Interventions
RADIATIONsecond propeller arm scanner
The experimental procedure is to conduct a second helical scanner strictly centered on the heart, 10 minutes after the first helix without inject contrast medium, to assess late enhancement.
Sponsors
University Hospital, Rouen
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Man or woman * Major patient * Patient with electrical, biological and clinical signs of myocardial infarction, with late presentation (\>24 hours) * Creatinine clearance (calculated using the Cockcroft (\<age 65) or MDRD (\> 65 years))formula \> 30 ml / min. * Affiliation to the french social security scheme. * Women of childbearing age: Negative pregnancy test (urine test). * Postmenopausal women, menopause confirmation of diagnosis * Patient able to understand the spoken and written French. * Signature of informed consent
Exclusion criteria
* Collapsus or organ failure requiring urgent care in intensive care unit * Arrhythmia and/or non-reducible tachycardia. * History of allergic reaction after iodinated contrast medium injection. * History of nephrogenic systemic fibrosis. * History of claustrophobia * Unbalanced asthma. * Acute pulmonary edema. * Pregnant or breastfeeding women. * Clinical signs of thyrotoxicosis. * Person placed under judicial protection, * Patient suffering from serious psychiatric disease. * Patients participating in another clinical trial. * Contraindication to MRI
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of patient with a possible evaluation of myocardial viability using dual-energy cardiac CT | Day 4 | To study the sensitivity of dual-energy cardiac CT for the evaluation of myocardial viability, in patients with late presentation myocardial infarction. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of patient with a possible evaluation of myocardial viability using cardiac MRI | Day 4 | To study the sensitivity of cardiac MRI for the evaluation of myocardial viability in patients with late presentation myocardial infarction. |
Countries
France
Contacts
PRINCIPAL_INVESTIGATORBenjamin DUBOURG, Doctor
University Hospital, Rouen
STUDY_DIRECTORJean-Nicolas DACHER, Professor
University Hospital, Rouen
Outcome results
None listed