Survival and Recovery From Postmyocardial Infarction Apical Wall Rupture With a Complex Course.

Ventricular wall rupture is associated with poor outcomes subsequent to an acute myocardial infarction. We describe a case of postmyocardial infarction apical wall rupture following percutaneous coronary intervention. Our case emphasizes the importance of swift evaluation, diagnosis, and management to enhance survival in individuals confronting this critical condition.

Treatment of left main coronary artery thrombus during SARS-CoV-2: early surgical revascularization is key.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause a hypercoagulable state leading to coronary artery thrombosis. The optimal management of this phenomenon has not been well elucidated. We describe a 38-year-old male who developed an ST-elevation myocardial infarction secondary to a left main coronary artery thrombus after SARS-CoV-2. The patient failed anticoagulation and fibrinolysis and developed decompensated heart failure. Ultimately, the patient underwent surgical revascularization, which led to full recovery. This highlights the need for refinement in this population. We recommend that early surgical intervention be considered in patients with ST-elevation myocardial infarction secondary to left main coronary artery thrombus in the setting of SARS-CoV-2.

Characterization of dynamic changes in cardiac microstructure after reperfused ST-elevation myocardial infarction by biphasic diffusion tensor cardiovascular magnetic resonance.

BACKGROUND AND AIMS: Microstructural disturbances underlie dysfunctional contraction and adverse left ventricular (LV) remodelling after ST-elevation myocardial infarction (STEMI). Biphasic diffusion tensor cardiovascular magnetic resonance (DT-CMR) quantifies dynamic reorientation of sheetlets (E2A) from diastole to systole during myocardial thickening, and markers of tissue integrity [mean diffusivity (MD) and fractional anisotropy (FA)]. This study investigated whether microstructural alterations identified by biphasic DT-CMR: (i) enable contrast-free detection of acute myocardial infarction (MI); (ii) associate with severity of myocardial injury and contractile dysfunction; and (iii) predict adverse LV remodelling. METHODS: Biphasic DT-CMR was acquired 4 days (n = 70) and 4 months (n = 66) after reperfused STEMI and in healthy volunteers (HVOLs) (n = 22). Adverse LV remodelling was defined as an increase in LV end-diastolic volume ≥ 20% at 4 months. MD and FA maps were compared with late gadolinium enhancement images. RESULTS: Widespread microstructural disturbances were detected post-STEMI. In the acute MI zone, diastolic E2A was raised and systolic E2A reduced, resulting in reduced E2A mobility (all P < .001 vs. adjacent and remote zones and HVOLs). Acute global E2A mobility was the only independent predictor of adverse LV remodelling (odds ratio .77; 95% confidence interval .63-.94; P = .010). MD and FA maps had excellent sensitivity and specificity (all > 90%) and interobserver agreement for detecting MI presence and location. CONCLUSIONS: Biphasic DT-CMR identifies microstructural alterations in both diastole and systole after STEMI, enabling detection of MI presence and location as well as predicting adverse LV remodelling. DT-CMR has potential to provide a single contrast-free modality for MI detection and prognostication of patients after acute STEMI.

Do collaterals to infarct bed in STE-ACS patients undergoing emergent percutaneous coronary revascularization matter? An assessment of a prospective pool for in-hospital course.

BACKGROUND: Limited data exist on the role of coronary collaterals circulation (CCC) in patients with ST-elevation acute coronary syndrome (STE-ACS). This study aimed to assess CCC and the in-hospital course of patients with CCC undergoing primary percutaneous coronary intervention (pPCI). METHODS: The study included consecutive STE-ACS patients undergoing pPCI. Good CCC was defined as Rentrop collateral score (RCS) of 2-3. Patients with good and poor CCC were compared regarding clinical characteristics, angiographic patterns, and hospital course. RESULTS: In the sample of 4683 patients, mean age was 55.6 ± 11 years, and 78.8 % were male. Good CCC was observed in 499 (10.7 %) patients. The rate of intra-procedure slow-flow/no-reflow (SF/NR) was 29.9 % vs. 20.5 % (p < 0.001), and the rate of composite adverse clinical outcomes (CACO) was 21.2 % vs. 19 % (p = 0.225) for patients with good and poor CCC, respectively. Multivariable analysis identified left ventricular end-diastolic pressure (LVEDP), multi-vessel disease (MVD), and thrombus grade ≥4 as independent predictors of good CCC, with adjusted odds ratios of 0.98 [0.97-0.99], 1.69 [1.35-2.10], and 3.45 [2.64-4.52], respectively. In propensity-matched cohorts, the intra-procedure SF/NR rate was 29.9 % vs. 26.9 % (p = 0.292), and the rate of CACO was 21.2 % vs. 23.4 % (p = 0.403) for patients with good and poor CCC, respectively. CONCLUSION: Angiographic evidence of good CCC in STE-ACS patients was limited. Good CCC was associated with a higher prevalence of MVD, high thrombus burden, and low pre-procedure LVEDP, resulting in a higher incidence of intra-procedure SF/NR. However, the CACO did not differ significantly between patients with good and poor CCC.

Association between haemoglobin decline and long-term outcomes in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention.

OBJECTIVE: To explore the association between in-hospital haemoglobin decline and long-term mortality and major adverse cardiovascular and cerebrovascular events (MACCE) among ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI). METHODS: This retrospective analysis included adult patients who underwent primary PCI for STEMI. Haemoglobin levels were recorded at admission and 48-72 h later. Patients were divided into two groups based on the extent of haemoglobin decline: low (<3 g/dl or no decline) and high (≥3 g/dl). The primary endpoint was all-cause mortality at long-term follow-up. The secondary endpoint was MACCE. RESULTS: Patients were divided into two groups: low group (n = 665) and high group (n = 111). The mortality rate was significantly higher in the high group (72 of 111 patients; 65%) than in the low group (185 of 655 patients; 28%). Propensity score matching confirmed this association, with higher mortality (41 of 79 patients [52%] versus 25 of 79 patients [32%]) and MACCE rates (56 of 79 patients [71%] versus 41 of 79 patients [52%]) in the high group compared with the low group, respectively. CONCLUSION: There was a significant association between in-hospital haemoglobin decline, even without visible bleeding, and increased long-term mortality and MACCE in STEMI patients undergoing primary PCI.

Addressing disparities in the long-term mortality risk in individuals with non-ST segment myocardial infarction (NSTEMI) by diabetes mellitus status: a nationwide cohort study.

AIMS/HYPOTHESIS: The aim of this study was to investigate how diabetes mellitus affects longer term outcomes in individuals presenting to hospital with non-ST segment elevation myocardial infarction (NSTEMI). METHODS: We analysed data from 456,376 adults hospitalised between January 2005 and March 2019 with NSTEMI from the UK Myocardial Ischaemia National Audit Project (MINAP) registry, linked with Office for National Statistics death reporting. We compared outcomes and quality of care by diabetes status. RESULTS: Individuals with diabetes were older (median age 74 vs 73 years), were more often of Asian ethnicity (13% vs 4%) and underwent revascularisation (percutaneous coronary intervention or coronary artery bypass graft surgery) (38% vs 40%) less frequently than those without diabetes. The mortality risk for those with diabetes compared with those without was significantly higher at 30 days (HR 1.19, 95% CI 1.15, 1.23), 1 year (HR 1.28, 95% CI 1.26, 1.31), 5 years (HR 1.36, 95% CI 1.34, 1.38) and 10 years (HR 1.39, 95% CI 1.36, 1.42). In individuals with diabetes, higher quality inpatient care, assessed by opportunity-based quality indicator (OBQI) score category ('poor', 'fair', 'good' or 'excellent'), was associated with lower mortality rates compared with poor care (good: HR 0.74, 95% CI 0.73, 0.76; excellent: HR 0.69, 95% CI 0.68, 0.71). In addition, compared with poor care, excellent care in the diabetes group was associated with the lowest mortality rates in the diet-treated and insulin-treated subgroups (diet-treated: HR 0.64, 95% CI 0.61, 0.68; insulin-treated: HR 0.69, CI 0.66, 0.72). CONCLUSION/INTERPRETATION: Individuals with diabetes experience disparities during inpatient care following NSTEMI. They have a higher risk of long-term mortality than those without diabetes, and higher quality inpatient care may lead to better long-term survival.

Colchicine effect on biomarkers of cardiac remodelling and atherosclerosis in ST-elevation myocardial infarction: A randomized controlled trial.

AIMS: Owing to its underlying inflammatory nature, atherosclerotic cardiovascular disease remains the leading global cause of mortality, particularly post-ST-elevation myocardial infarction (STEMI), a condition with significant risk for further cardiovascular events and mortality. This study aimed to investigate colchicine's effect on inflammation, cardiac remodelling and atherosclerotic risk in STEMI patients. METHODS: We conducted a randomized controlled study on 88 STEMI patients undergoing percutaneous coronary intervention. Eligible patients were randomly assigned to 1 of 2 groups. The control group received the guideline-directed medical therapy for STEMI, and the test group received guideline-directed medical therapy and 0.5 mg colchicine twice daily for 3 months. The soluble suppressor of tumorigenicity (sST2), interleukin-1ß, lipid profile parameters, triglyceride (TG)/high-density lipoprotein (HDL-C) ratio levels and left ventricular ejection fraction were evaluated for patients at baseline and the end of the 3 months. RESULTS: No significant effects were reported for colchicine on sST2, interleukin-1ß levels or left ventricular ejection fraction. Colchicine significantly lowered TG levels vs. controls, 134 (46-353) vs. 176 (72-825) respectively, P = .02, as well as TG/HDL-C ratio levels, 4.16 (2.75-5.24) vs. 5.11 (3.51-8.33),` respectively, P = .024. sST2 levels of the studied cohort were positively correlated with their TG/HDL-C ratio levels (R = .459, P < .001) at the end of follow-up. CONCLUSION: Our study highlights a promising impact of colchicine on atherosclerosis and cardiac remodelling factors in STEMI patients. Colchicine significantly reduced TG levels and TG/HDL-C ratio and was safe and well tolerated. Larger long-term studies powered to assess clinical outcomes of remodelling are necessary to confirm its beneficial effects in STEMI. GOV REGISTRATION ID: NCT06054100.

Osseodensification technique in crestal maxillary sinus elevation-A narrative review.

Osseodensification is a novel approach that has significantly advanced the field of implant dentistry, particularly in the context of transcrestal maxillary sinus floor elevation. This technique involves the use of specially designed burs that compact and densify bone along the osteotomy walls, thereby enhancing implant primary stability and facilitating osseointegration in low-density bone. This article reviews the historical evolution of implant site preparation, and the biomechanical, histological, and clinical evidence of osseodensification with a special focus on its application in sinus floor augmentation. The integration of this technique into contemporary practice represents a paradigm shift, offering a minimally invasive and efficient solution for addressing the challenges of posterior maxilla, with improved patient-reported outcomes and low complication rate. Three different protocols for sinus lift and implant placement using osseodensification burs are proposed based on available literature, and risk factors for Schneiderian membrane perforation based on residual bone height are discussed, along with implant-related outcomes and patient-reported outcome measures. The potential for osseodensification to become a standard practice in sinus floor augmentation is emphasized, highlighting key aspects such as surgical protocol and patient selection.

A top-down spatial scenario approach for identifying the locations of rainwater harvesting sites in an urban region.

Alternative water sources are necessary in developing nations because surface water is not always accessible, and groundwater is depleted. In such situations, rainwater harvesting is considered a promising sustainable water resource management solution. Numerous studies have been conducted to determine suitable locations for rainwater harvesting (RWH) using bottom-up approaches applied to large watersheds. The bottom-up methods begin with various geographic criteria and end with regions suitable for RWH intervention, even considering the distance from settlements to be one of the criteria, excluding urban areas from RWH site identification. This study developed a top-down methodology that began with the distributed pinpoint locations of potential RWH sites, as determined by distributed flow accumulation values produced from a digital elevation model (DEM), and then filtered out the sites based on various criteria in the context of urban areas. The flow accumulation values were apportioned according to the flow-contributing area of each RWH site. Five flow-contributing areal scenarios corresponding to 1 km2, 2.5 km2, 5 km2, 7.5 km2, and 10 km2 were considered in this study, as it is challenging to choose a suitable location for RWH sites in urban zones for efficient water storage owing to a variety of land uses. Based on this technique, a case study was conducted in Jaipur, Rajasthan, India, where it was found that the volumetric potential of rainwater storage is maximum (403,679,424.9 cu. m) for 1 km2 and minimum (169,951,322 cu. m) for 10 km2 flow contributing areal distribution per RWH site.

Influence of curing mode and aging on the bonding performance of universal adhesives in coronal and root dentin.

BACKGROUND: This study aims to evaluate the microtensile bond strength (µTBS) of different resin composite restorations bonded to mid-coronal dentin and proximal root dentin using light-cured, chemical-cured, and dual-cured adhesives immediately and after aging. Nanoleakage and degree of cure were also assessed. METHODS: Eighty-four molars were divided into mid-coronal dentin and proximal root dentin. Each group was further subdivided into three subgroups based on the restorative systems used, which involved the utilization of light-cured, chemical-cured, and dual-cured adhesives. Half of the specimens underwent µTBS testing after 24 h, while the other half after aging. Representative specimens were analyzed for nanoleakage. The degree of cure of the tested adhesive systems was also assessed. RESULTS: Aging showed a significant negative effect on µTBS results and led to increased nanoleakage (p < 0.001). Furthermore, in all subgroups, the µTBS values of proximal root dentin were lower compared to mid-coronal dentin, except in the aged subgroup for the system utilizing the dual-cured adhesive. The restorative systems with chemical and dual-cured adhesives demonstrated comparable bonding properties. However, the system with the light-cured adhesive exhibited the worst bonding properties after aging when bonded to proximal root dentin and cured at a large distance (p < 0.05). CONCLUSIONS: All tested restorative systems were negatively affected by aging, and the regional dentin had variable effects on the bonding properties. Clinicians should exercise caution when using the tested light-cured adhesive in areas where the curing distance exceeds 3 mm.

Clinical and Coronary Angiographic Insights Into Acute ST-Elevation Myocardial Infarction in Young Patients: A Study From a Tertiary Care Cardiac ICU.

Background This investigation addresses the major effects of early-onset coronary artery disease (CAD) on community health, noting its association with elevated incidences of recurrent ischemic events and mortality. The study specifically explores the contributing factors, clinical symptoms, angiographic findings, and management strategies for individuals aged 45 or younger who experience their initial ST-elevation myocardial infarction (STEMI). Methodology This observational study took place over a six-month period within the cardiology unit, involving 100 sequential patients diagnosed with STEMI. Results With a mean age of 42.5 years, the research had 100 patients, of which nine (9%) were under 25, 24 (24%) were between 26 and 35, and 67 (67%) were over 36. Of these, 89 (89%) were male. The following risk variables were found: obstructive CAD, smoking, being overweight, diabetes, hypertension, chest discomfort, and syncope. In 99 patients (99%), the most prevalent symptom was chest discomfort. Most often impacted was the left anterior descending (LAD) artery in 24 patients (24%), then the right coronary artery in 14 patients (14%). A total of 50 patients (50%) had percutaneous coronary intervention (PCI), with 15 patients (15%) undergoing elective PCI, 10 patients (10%) with pharmaco-invasive PCI, and 20 patients (20%) receiving primary PCI. In eight cases (8%), coronary artery bypass grafting (CABG) was required. Furthermore, 40 patients (40%) were under medical care, and 32 patients (32%) had recanalized and normal coronaries. No mortality was recorded in this study. Conclusions Acute myocardial infarction is most frequently seen in very young adult males, and the most common risk factor is smoking. The most common clinical manifestation, anterior wall myocardial infarction, was caused by the main source of involvement, the LAD artery.

Socioeconomic Barriers to Receiving Early Salvage Radiotherapy for Locally Advanced Prostate Adenocarcinoma: A Retrospective Single-Center Study.

Purpose This study aimed to identify factors associated with delays in initiating early salvage radiation therapy in prostate cancer patients with prostate-specific antigen (PSA) failure after prostatectomy. Methods We conducted a single-institution, retrospective study of patients receiving salvage radiation therapy after radical prostatectomy from 2011 to 2022. Patient demographics and clinical data were examined to identify factors that may have influenced the time to start of radiation therapy after surgery. Utilizing a PSA cut off of 0.25 ng/ml or less, we classified patients as receiving either early "PSA low" or late "PSA high" salvage therapy depending on their PSA at the time of initiating treatment. Results Of the 81 patients evaluated, the median age was 61.9 years (IQR 57.9 - 66.5), with most presenting with pT3 (65.4%), Grade Group 2 disease (35.8%), and positive margins 55%). Median PSA at salvage radiation therapy commencement was 0.30 ng/mL (0.18 - 0.48). 40 patients completed early salvage and 41 patients completed late salvage in the overall cohort. A significant association was found between patient insurance carrier and pre-radiation PSA levels. Patients with HMO (Health Maintenance Organization) or PPO (Preferred Provider Organization) insurance were more likely to complete late salvage radiation compared to non-managed Medicare patients (HMO OR 4.0, p <0.05 & PPO OR 3.3 p <0.05 vs non-managed Medicare). All uninsured patients in the cohort received late salvage radiation. Conclusions Insurance type was significantly associated with the timing of salvage radiation therapy post-prostatectomy, suggesting a relationship with providers requiring prior authorization (HMO and PPO coverage). This study supports proper PSA surveillance, in particular for those with HMO or PPO coverage.

ECMO versus IABP for STEMI Patients Complicated by Cardiogenic Shock undergoing Primary PCI: A Chinese National Study and Propensity-matched Analysis.

OBJECTIVES: This study investigated the association between the utilization of extracorporeal membrane oxygenation (ECMO) or intra-aortic balloon pump (IABP) and in-hospital mortality among patients with ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock undergoing primary percutaneous coronary intervention (PCI). METHODS: Data encompassing 9635 cases of STEMI complicated by cardiogenic shock and treated with primary PCI using ECMO/IABP support were retrieved from the Chinese Cardiovascular Association database (2019-2021). We conducted an analysis to assess in-hospital survival disparities among percutaneous mechanical circulatory device recipients and explore the potential advantages of ECMO through multivariable logistic regression analysis within a propensity score-matched (1:2) cohort population. RESULTS: ECMO was administered to 2028 patients, while IABP was utilized in 7607 patients. Patients supported by ECMO showed a lower in-hospital mortality compared with those supported by IABP (7.2% vs. 15.1%, p<0.001). Within the propensity-matched (case : control=1:2) cohort, we noted a 34% reduced risk of in-hospital mortality among patients supported by ECMO compared to those supported by IABP (7.7% vs. 11.7%; odds ratio = 0.66; 95% CI, 0.53-0.80; p< 0.001) independent of age, sex, systolic blood pressure, obesity, smoke, hypertension, diabetes, dyslipidaemia, family history of coronary artery disease, coronary artery disease, stroke, atrial filiation, peripheral artery disease, chronic kidney disease, vascular lesion sites, 3A-grade hospital, and regional distributions in China. CONCLUSIONS: Among patients undergoing primary PCI for STEMI complicated by cardiogenic shock, ECMO was associated with better in-hospital survival than IABP.

Reevaluate the effect of ACEI/ARB therapy at discharge on patients with STEMI in the contemporary reperfusion era.

BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) had beneficial effects on clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) in the pre-reperfusion or thrombolytic era. It is unknown if the benefits persist in the contemporary reperfusion era. OBJECTIVES: We sought to determine if ACEI/ARB improves clinical outcomes of patients with STEMI in the contemporary reperfusion era according to the reperfusion strategy. METHODS: 12596 patients were analyzed from the prospective, nationwide, multicenter China Acute Myocardial Infarction (CAMI) Registry. These patients were classified into the no reperfusion group (n=6004) and the primary percutaneous coronary intervention (PCI) group (n=6592). Two-year all-cause mortality and major adverse cardiac and cerebrovascular events (MACCE) were compared. RESULTS: In the no reperfusion group, ACEI/ARB therapy at discharge may reduce the incidences of 30-day MACCE (4.7% vs 7.4%; adjusted hazard ratio [HR]: 0.67; 95% confidence interval [CI]: 0.53-0.85; P<0.001), stroke (0.5% vs 1.1%; adjusted HR: 0.41; 95% CI: 0.21-0.83; P=0.01), and revascularization (2.1% vs 3.1%; adjusted HR: 0.66; 95% CI: 0.46-0.94; P=0.02) compared to patients not treated with ACEI/ARB. Patients treated with ACEI/ARB also showed a lower rate of two-year MACCE (17.0% versus 19.1%; adjusted HR: 0.87; 95% CI: 0.76-0.99; P=0.04). No differences were observed in the remaining outcomes. In the primary PCI group, no differences were observed for all examined outcomes before and after multivariate adjustments. CONCLUSIONS: Treatment with ACEI/ARB at discharge may reduce cardiovascular events in STEMI patients not receiving reperfusion, while no significant benefits were observed in those receiving primary PCI.

Temporal Augmentation Effect of Reduction Malarplasty: Application of our Bracing Technique with Zygomatic Arch Elevation.

BACKGROUND: A broad midface is usually accompanied by temporal depression. Traditional reduction malarplasty may visually improve the temporal depression by the inward reduction of zygomatic arch, but also has a high risk of soft tissue sagging. Our bracing technique has been reported to have an anti-sagging effect and may have a temporal augmentation effect as observed during our long-term clinical practice. METHODS: Data of patients who received reduction malarplasty with our bracing technique from September 2015 to July 2023 were retrospectively collected. The pre-op and post-op CT images of those who met the inclusion criteria were used for three-dimensional reconstruction and measurements of the thickness and volume of the temporal soft tissue as well as the elevation distance of zygomatic arch. RESULTS: Fifty-eight patients with an average follow-up of 18.4 ± 9.1 months were included. Despite mild thinning of the temporalis muscle after reduction malarplasty, the overall thickness of the temporal soft tissue significantly increased due to the significant thickening of the temporal adipose-fascial layer. There was a 0.5 ml-increase in the temporal volume although without statistical difference. No significant correlation was detected between the elevation distance of zygomatic arch and the temporal thickness or volume change. CONCLUSIONS: The bracing technique of reduction malarplasty not only plays an anti-sagging role, but also has a temporal augmentation effect through the superior bracing by the elevation and rigid fixation of the zygomatic arch. It adds brilliance to the traditional technique and can be suggested especially when the patients are disturbed by temporal depression. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Comparison of three approaches for treating the bony access window in lateral sinus floor elevation: a retrospective analysis.

The aim of this study was to retrospectively determine the effects of applying different treatment methods to the bony access window on the healing outcomes in lateral sinus floor elevation (SFE). Lateral SFE with implant placement was performed in 131 sinuses of 105 patients. The following three treatment methods were applied to the bony access window: application of a collagen barrier (group CB), repositioning the bone fragment (group RW) and untreated (group UT). Radiographic healing in the window area, augmented bone height changes and marginal bone level changes were examined. Mixed logistic and mixed linear models were analyzed. Over 4.3 ± 1.4 years of follow-up, the implant survival rate was 100% in groups CB and UT, and 96.9% in group RW. The treatment applied to the window did not significantly influence the radiographic healing in the window area, augmented bone height changes or marginal bone level changes (p > 0.05). The healed window areas had generally flat morphologies and were fully corticalized. The mean changes in the augmented bone were less than 1.5 mm in all groups. Marginal bone level changes were minimal. In conclusion, Healing outcomes were not different among three different methods to treat the bony access window in lateral SFE.

Myocardial Infarction and Pulmonary Embolism: Causal or Temporal Association?

Ischemic electrocardiographic changes in the setting of pulmonary embolism are typically the result of dilatation of the right cavities and/or right ventricular ischaemia, without coronary occlusion. We present a patient with pulmonary embolism and concomitant myocardial infarction, with the aim of exploring the possible links between these 2 distinct entities.

Hepatic T1 Mapping as a Novel Cardio-Hepatic Axis Imaging Biomarker Early after STEMI.

BACKGROUND: The hepatic response after ST-elevation myocardial infarction (STEMI) may be associated with mortality and morbidity. We aimed to assess the cardio-hepatic axis post-STEMI using cardiovascular magnetic resonance (CMR). METHODS: This prospective, observational, single-centre study included consecutive STEMI patients who underwent CMR after primary angioplasty from January 2015 to January 2019. Standard infarct characteristics were analysed, and hepatic T1 and hepatic extracellular volume (ECV) were assessed using pre- and post-contrast T1-mapping sequences. The primary endpoint was the relationship between native hepatic T1-values and ischemic right ventricular (RV) involvement, determined by RV ejection fraction (EF) dysfunction and/or the presence of RV acute myocardial infarction (AMI). The diagnostic performance of hepatic T1 values for detecting RV involvement was assessed using the area under the receiver operating characteristic curve (AUC). RESULTS: Of 177 consecutive STEMI patients undergoing CMR, 142 were included. Patients with RV ischemic involvement, compared to those without, had significantly higher native hepatic T1 (p < 0.001) and hepatic ECV (p = 0.016). Hepatic T1 values demonstrated a good diagnostic performance in detecting RV involvement (AUC 0.826, p < 0.001) and correlated positively with NT-proBNP values (r = 0.754, p < 0.001). Patients with high hepatic T1 values (>605 ms) had significantly higher NT-proBNP levels (<0.001), larger RV end-diastolic volume (p < 0.001), lower RV-EF (p < 0.001), and a higher prevalence of RV AMI (p = 0.022) compared to those with hepatic T1 ≤ 605 ms, while left ventricular EF and infarct size were similar. Multivariable logistic regression analysis identified RV-EF (p = 0.010) and NT-proBNP values (p < 0.001) as independent predictors of increased hepatic T1 values. Patients with increased hepatic T1 values had a higher rate of re-hospitalization for heart failure at 17-month follow-up (12.1% vs 2.0%, p = 0.046). CONCLUSIONS: Hepatic T1 mapping has emerged as a possible novel imaging biomarker of the cardio-hepatic axis in STEMI, being associated with RV involvement and increased NT-proBNP values.