New Study Links Faster Reperfusion to Less Severe Heart Damage After Heart Attack

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PASADENA, Calif. — October 9, 2023 — A new international study co-authored by Dr. Robert A. Kloner, Chief Science Officer and Scientific Director of Cardiovascular Research at Huntington Medical Research Institutes (HMRI), demonstrates that shorter time from symptom onset to reperfusion is strongly associated with smaller infarct size and better heart function after ST-segment elevation myocardial infarction (STEMI).

Published in European Heart Journal – Cardiovascular Imaging, the paper — “Impact of Symptom-to-Reperfusion Time on Transmural Infarct Extent and Left Ventricular Strain in Patients With ST-Segment Elevation Myocardial Infarction: A 3-Dimensional View on the Wavefront Phenomenon” — used advanced cardiac magnetic resonance (CMR) imaging to quantify heart muscle injury and recovery.

The research team — Ahmet Demirkiran, Casper Beijnink, Robert A. Kloner, Luuk H.G.A. Hopman, Nina W. van der Hoeven, Nikki van Pouderoijen, Gladys N. Janssens, Henk Everaars, Maarten A.H. van Leeuwen, Albert C. van Rossum, Niels van Royen, Lourens F.H.J. Robbers, and Robin Nijveldt — evaluated 108 STEMI patients who underwent successful primary percutaneous coronary intervention (PPCI).

Key findings include:

  • Patients treated within 160 minutes of symptom onset had significantly smaller infarcts on CMR imaging.

  • Faster reperfusion led to better global left-ventricular (LV) circumferential and radial strain, indicators of stronger heart muscle function.

  • The degree of transmural infarction (depth of muscle damage) correlated closely with residual LV strain, linking early intervention to sustained cardiac performance.

  • In multivariable regression, circumferential strain independently predicted infarct severity, underscoring its diagnostic value for patient recovery.

“These findings reinforce the critical importance of rapid reperfusion,” said Dr. Kloner. “Every minute of delay translates to deeper tissue damage and reduced functional recovery. Advanced imaging now shows this in three dimensions.”

The study provides new CMR-based evidence for the long-recognized ‘wavefront phenomenon’ — the progressive spread of myocardial necrosis over time — and highlights the lasting benefits of early intervention in heart-attack management.

Full article: European Heart Journal – Cardiovascular Imaging, October 2023