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Rapid Initial Reduction of Hyperenhanced Myocardium After Reperfused First Myocardial Infarction Suggests Recovery of the Peri-Infarction Zone One-Year Follow-Up by MRI

Engblom, Henrik LU ; Hedström, Erik LU ; Heiberg, Einar LU ; Wagner, Galen S.; Pahlm, Olle LU and Arheden, Håkan LU (2009) In Circulation Cardiovascular Imaging 2(1). p.47-55
Abstract
Background-The time course and magnitude of infarct involution, functional recovery, and normalization of infarct-related electrocardiographic (ECG) changes after acute myocardial infarction (MI) are not completely known in humans. We sought to explore these processes early after MI and during infarct-healing using cardiac MRI. Methods and Results-Twenty-two patients with reperfused first-time MI were examined by MRI and ECG at 1, 7, 42. 182, and 365 days after infarction. Global left ventricular function and regional wall thickening were assessed by cine MRI, and injured myocardium was depicted by delayed contrast-enhanced MRI. Infarct size by ECG was estimated by QRS scoring. The reduction of hyperenhanced myocardium occurred... (More)
Background-The time course and magnitude of infarct involution, functional recovery, and normalization of infarct-related electrocardiographic (ECG) changes after acute myocardial infarction (MI) are not completely known in humans. We sought to explore these processes early after MI and during infarct-healing using cardiac MRI. Methods and Results-Twenty-two patients with reperfused first-time MI were examined by MRI and ECG at 1, 7, 42. 182, and 365 days after infarction. Global left ventricular function and regional wall thickening were assessed by cine MRI, and injured myocardium was depicted by delayed contrast-enhanced MRI. Infarct size by ECG was estimated by QRS scoring. The reduction of hyperenhanced myocardium occurred predominantly during the first week after infarction (64% of the 1-year reduction). Furthermore, during the first week the amount of nonhyperenhanced myocardium increased significantly (P<0.001,), although the left ventricular mass remained unchanged. Left ventricular ejection fraction increased gradually, whereas the greater the regional transmural extent of hyperenhancement at day 1, the later the recovery of regional wall thickening. Regional wall thickening decreased progressively with increasing initial transmural extent of hyperenhancement (P-trend<0.0001). The time course and magnitude of decrease in QRS score corresponded with the reduction of hyperenhanced myocardium. Conclusions-The early reduction of hyperenhanced myocardium May reflect recovery of hyperenhanced, reversibly injured myocardium), which must be considered when predicting functional recovery from delayed contrast-enhanced MRI findings early after infarction. Also, the time course and magnitude for reduction of hyperenhanced myocardium were associated with normalization of infarct-related ECG changes. (Circ Cardiovasc Imaging. 2009;2:47-55.) (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
keywords
Myocardial Infarction: pathology, Heterocyclic Compounds: diagnostic use, Gadolinium: diagnostic use, Heart Ventricles: pathology, Myocardial Infarction: physiopathology, Organometallic Compounds: diagnostic use, Myocardium: pathology
in
Circulation Cardiovascular Imaging
volume
2
issue
1
pages
47 - 55
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000266129000009
  • pmid:19808564
  • scopus:70349762573
ISSN
1942-0080
DOI
10.1161/CIRCIMAGING.108.802199
language
English
LU publication?
yes
id
9b051946-c4da-4c43-b2c2-1f609760f717 (old id 1426210)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19808564?dopt=Abstract
date added to LUP
2009-06-26 13:28:37
date last changed
2017-11-19 03:29:22
@article{9b051946-c4da-4c43-b2c2-1f609760f717,
  abstract     = {Background-The time course and magnitude of infarct involution, functional recovery, and normalization of infarct-related electrocardiographic (ECG) changes after acute myocardial infarction (MI) are not completely known in humans. We sought to explore these processes early after MI and during infarct-healing using cardiac MRI. Methods and Results-Twenty-two patients with reperfused first-time MI were examined by MRI and ECG at 1, 7, 42. 182, and 365 days after infarction. Global left ventricular function and regional wall thickening were assessed by cine MRI, and injured myocardium was depicted by delayed contrast-enhanced MRI. Infarct size by ECG was estimated by QRS scoring. The reduction of hyperenhanced myocardium occurred predominantly during the first week after infarction (64% of the 1-year reduction). Furthermore, during the first week the amount of nonhyperenhanced myocardium increased significantly (P&lt;0.001,), although the left ventricular mass remained unchanged. Left ventricular ejection fraction increased gradually, whereas the greater the regional transmural extent of hyperenhancement at day 1, the later the recovery of regional wall thickening. Regional wall thickening decreased progressively with increasing initial transmural extent of hyperenhancement (P-trend&lt;0.0001). The time course and magnitude of decrease in QRS score corresponded with the reduction of hyperenhanced myocardium. Conclusions-The early reduction of hyperenhanced myocardium May reflect recovery of hyperenhanced, reversibly injured myocardium), which must be considered when predicting functional recovery from delayed contrast-enhanced MRI findings early after infarction. Also, the time course and magnitude for reduction of hyperenhanced myocardium were associated with normalization of infarct-related ECG changes. (Circ Cardiovasc Imaging. 2009;2:47-55.)},
  author       = {Engblom, Henrik and Hedström, Erik and Heiberg, Einar and Wagner, Galen S. and Pahlm, Olle and Arheden, Håkan},
  issn         = {1942-0080},
  keyword      = {Myocardial Infarction: pathology,Heterocyclic Compounds: diagnostic use,Gadolinium: diagnostic use,Heart Ventricles: pathology,Myocardial Infarction: physiopathology,Organometallic Compounds: diagnostic use,Myocardium: pathology},
  language     = {eng},
  number       = {1},
  pages        = {47--55},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Circulation Cardiovascular Imaging},
  title        = {Rapid Initial Reduction of Hyperenhanced Myocardium After Reperfused First Myocardial Infarction Suggests Recovery of the Peri-Infarction Zone One-Year Follow-Up by MRI},
  url          = {http://dx.doi.org/10.1161/CIRCIMAGING.108.802199},
  volume       = {2},
  year         = {2009},
}