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Cardiovascular magnetic resonance of the myocardium at risk in acute reperfused myocardial infarction: comparison of T2-weighted imaging versus the circumferential endocardial extent of late gadolinium enhancement with transmural projection

Ubachs, Joey LU ; Engblom, Henrik LU ; Erlinge, David LU orcid ; Jovinge, Stefan LU ; Hedström, Erik LU orcid ; Carlsson, Marcus LU and Arheden, Håkan LU (2010) In Journal of Cardiovascular Magnetic Resonance 12.
Abstract
Background: In the situation of acute coronary occlusion, the myocardium supplied by the occluded vessel is subject to ischemia and is referred to as the myocardium at risk (MaR). Single photon emission computed tomography has previously been used for quantitative assessment of the MaR. It is, however, associated with considerable logistic challenges for employment in clinical routine. Recently, T2-weighted cardiovascular magnetic resonance (CMR) has been introduced as a new method for assessing MaR several days after the acute event. Furthermore, it has been suggested that the endocardial extent of infarction as assessed by late gadolinium enhanced (LGE) CMR can also be used to quantify the MaR. Hence, we sought to assess the ability of... (More)
Background: In the situation of acute coronary occlusion, the myocardium supplied by the occluded vessel is subject to ischemia and is referred to as the myocardium at risk (MaR). Single photon emission computed tomography has previously been used for quantitative assessment of the MaR. It is, however, associated with considerable logistic challenges for employment in clinical routine. Recently, T2-weighted cardiovascular magnetic resonance (CMR) has been introduced as a new method for assessing MaR several days after the acute event. Furthermore, it has been suggested that the endocardial extent of infarction as assessed by late gadolinium enhanced (LGE) CMR can also be used to quantify the MaR. Hence, we sought to assess the ability of endocardial extent of infarction by LGE CMR to predict MaR as compared to T2-weighted imaging. Methods: Thirty-seven patients with early reperfused first-time ST-segment elevation myocardial infarction underwent CMR imaging within the first week after percutaneous coronary intervention. The ability of endocardial extent of infarction by LGE CMR to assess MaR was evaluated using T2-weighted imaging as the reference method. Results: MaR determined with T2-weighted imaging (34 +/- 10%) was significantly higher (p < 0.001) compared to the MaR determined with endocardial extent of infarction (23 +/- 12%). There was a weak correlation between the two methods (r(2) = 0.17, p = 0.002) with a bias of -11 +/- 12%. Myocardial salvage determined with T2-weighted imaging (58 +/- 22%) was significantly higher (p < 0.001) compared to myocardial salvage determined with endocardial extent of infarction (45 +/- 23%). No MaR could be determined by endocardial extent of infarction in two patients with aborted myocardial infarction. Conclusions: This study demonstrated that the endocardial extent of infarction as assessed by LGE CMR underestimates MaR in comparison to T2-weighted imaging, especially in patients with early reperfusion and aborted myocardial infarction. (Less)
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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Cardiovascular Magnetic Resonance
volume
12
publisher
BioMed Central (BMC)
external identifiers
  • wos:000276646800001
  • scopus:77954571219
  • pmid:20350309
ISSN
1097-6647
DOI
10.1186/1532-429X-12-18
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Hematopoietic Stem Cell Laboratory (013022012), Cardiology (013230026), Department of Clinical Physiology (Lund) (013013000)
id
7ddc090d-c0dd-4c60-b143-5539d687870d (old id 1603015)
date added to LUP
2016-04-01 10:18:37
date last changed
2023-01-02 03:20:05
@article{7ddc090d-c0dd-4c60-b143-5539d687870d,
  abstract     = {{Background: In the situation of acute coronary occlusion, the myocardium supplied by the occluded vessel is subject to ischemia and is referred to as the myocardium at risk (MaR). Single photon emission computed tomography has previously been used for quantitative assessment of the MaR. It is, however, associated with considerable logistic challenges for employment in clinical routine. Recently, T2-weighted cardiovascular magnetic resonance (CMR) has been introduced as a new method for assessing MaR several days after the acute event. Furthermore, it has been suggested that the endocardial extent of infarction as assessed by late gadolinium enhanced (LGE) CMR can also be used to quantify the MaR. Hence, we sought to assess the ability of endocardial extent of infarction by LGE CMR to predict MaR as compared to T2-weighted imaging. Methods: Thirty-seven patients with early reperfused first-time ST-segment elevation myocardial infarction underwent CMR imaging within the first week after percutaneous coronary intervention. The ability of endocardial extent of infarction by LGE CMR to assess MaR was evaluated using T2-weighted imaging as the reference method. Results: MaR determined with T2-weighted imaging (34 +/- 10%) was significantly higher (p &lt; 0.001) compared to the MaR determined with endocardial extent of infarction (23 +/- 12%). There was a weak correlation between the two methods (r(2) = 0.17, p = 0.002) with a bias of -11 +/- 12%. Myocardial salvage determined with T2-weighted imaging (58 +/- 22%) was significantly higher (p &lt; 0.001) compared to myocardial salvage determined with endocardial extent of infarction (45 +/- 23%). No MaR could be determined by endocardial extent of infarction in two patients with aborted myocardial infarction. Conclusions: This study demonstrated that the endocardial extent of infarction as assessed by LGE CMR underestimates MaR in comparison to T2-weighted imaging, especially in patients with early reperfusion and aborted myocardial infarction.}},
  author       = {{Ubachs, Joey and Engblom, Henrik and Erlinge, David and Jovinge, Stefan and Hedström, Erik and Carlsson, Marcus and Arheden, Håkan}},
  issn         = {{1097-6647}},
  language     = {{eng}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Journal of Cardiovascular Magnetic Resonance}},
  title        = {{Cardiovascular magnetic resonance of the myocardium at risk in acute reperfused myocardial infarction: comparison of T2-weighted imaging versus the circumferential endocardial extent of late gadolinium enhancement with transmural projection}},
  url          = {{http://dx.doi.org/10.1186/1532-429X-12-18}},
  doi          = {{10.1186/1532-429X-12-18}},
  volume       = {{12}},
  year         = {{2010}},
}