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Assessment of myocardium at risk with contrast enhanced steady-state free precession cine cardiovascular magnetic resonance compared to single-photon emission computed tomography

Sorensson, Peder; Heiberg, Einar LU ; Saleh, Nawsad; Bouvier, Frederic; Caidahl, Kenneth; Tornvall, Per; Ryden, Lars; Pernow, John and Arheden, Håkan LU (2010) In Journal of Cardiovascular Magnetic Resonance 12.
Abstract
Background: Final infarct size following coronary occlusion is determined by the duration of ischemia, the size of myocardium at risk (MaR) and reperfusion injury. The reference method for determining MaR, single-photon emission computed tomography (SPECT) before reperfusion, is impractical in an acute setting. The aim of the present study was to evaluate whether MaR can be determined from the contrast enhanced myocardium using steady-state free precession (SSFP) cine cardiovascular magnetic resonance (CMR) performed one week after the acute event in ST-elevation myocardial infarction (STEMI) patients with total coronary occlusion. Results: Sixteen patients with STEMI (age 64 +/- 8 years) received intravenous 99 m-Tc immediately before... (More)
Background: Final infarct size following coronary occlusion is determined by the duration of ischemia, the size of myocardium at risk (MaR) and reperfusion injury. The reference method for determining MaR, single-photon emission computed tomography (SPECT) before reperfusion, is impractical in an acute setting. The aim of the present study was to evaluate whether MaR can be determined from the contrast enhanced myocardium using steady-state free precession (SSFP) cine cardiovascular magnetic resonance (CMR) performed one week after the acute event in ST-elevation myocardial infarction (STEMI) patients with total coronary occlusion. Results: Sixteen patients with STEMI (age 64 +/- 8 years) received intravenous 99 m-Tc immediately before primary percutaneous coronary intervention. SPECT was performed within four hours. MaR was defined as the non-perfused myocardial volume derived with SPECT. CMR was performed 7.8 +/- 1.2 days after the myocardial infarction using a protocol in which the contrast agent was administered before acquisition of short-axis SSFP cines. MaR was evaluated as the contrast enhanced myocardial volume in the cines by two blinded observers. MaR determined from the enhanced region on cine CMR correlated significantly with that derived with SPECT (r(2) = 0.78, p < 0.001). The difference in MaR determined by CMR and SPECT was 0.5 +/- 5.1% (mean +/- SD). The interobserver variability of contrast enhanced cine SSFP measurements was 1.6 +/- 3.7% (mean +/- SD) of the left ventricle wall volume. Conclusions: Contrast enhanced SSFP cine CMR performed one week after acute infarction accurately depicts MaR prior to reperfusion in STEMI patients with total occlusion undergoing primary PCI. This suggests that a single CMR examination might be performed for determination of MaR and infarct size. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
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in
Journal of Cardiovascular Magnetic Resonance
volume
12
publisher
BioMed Central
external identifiers
  • wos:000279558800001
  • scopus:77955865520
ISSN
1097-6647
DOI
10.1186/1532-429X-12-25
language
English
LU publication?
yes
id
030e0e5d-adea-43a6-9ebe-923131bcb900 (old id 1657894)
date added to LUP
2010-08-24 13:20:03
date last changed
2018-07-08 03:11:22
@article{030e0e5d-adea-43a6-9ebe-923131bcb900,
  abstract     = {Background: Final infarct size following coronary occlusion is determined by the duration of ischemia, the size of myocardium at risk (MaR) and reperfusion injury. The reference method for determining MaR, single-photon emission computed tomography (SPECT) before reperfusion, is impractical in an acute setting. The aim of the present study was to evaluate whether MaR can be determined from the contrast enhanced myocardium using steady-state free precession (SSFP) cine cardiovascular magnetic resonance (CMR) performed one week after the acute event in ST-elevation myocardial infarction (STEMI) patients with total coronary occlusion. Results: Sixteen patients with STEMI (age 64 +/- 8 years) received intravenous 99 m-Tc immediately before primary percutaneous coronary intervention. SPECT was performed within four hours. MaR was defined as the non-perfused myocardial volume derived with SPECT. CMR was performed 7.8 +/- 1.2 days after the myocardial infarction using a protocol in which the contrast agent was administered before acquisition of short-axis SSFP cines. MaR was evaluated as the contrast enhanced myocardial volume in the cines by two blinded observers. MaR determined from the enhanced region on cine CMR correlated significantly with that derived with SPECT (r(2) = 0.78, p &lt; 0.001). The difference in MaR determined by CMR and SPECT was 0.5 +/- 5.1% (mean +/- SD). The interobserver variability of contrast enhanced cine SSFP measurements was 1.6 +/- 3.7% (mean +/- SD) of the left ventricle wall volume. Conclusions: Contrast enhanced SSFP cine CMR performed one week after acute infarction accurately depicts MaR prior to reperfusion in STEMI patients with total occlusion undergoing primary PCI. This suggests that a single CMR examination might be performed for determination of MaR and infarct size.},
  author       = {Sorensson, Peder and Heiberg, Einar and Saleh, Nawsad and Bouvier, Frederic and Caidahl, Kenneth and Tornvall, Per and Ryden, Lars and Pernow, John and Arheden, Håkan},
  issn         = {1097-6647},
  language     = {eng},
  publisher    = {BioMed Central},
  series       = {Journal of Cardiovascular Magnetic Resonance},
  title        = {Assessment of myocardium at risk with contrast enhanced steady-state free precession cine cardiovascular magnetic resonance compared to single-photon emission computed tomography},
  url          = {http://dx.doi.org/10.1186/1532-429X-12-25},
  volume       = {12},
  year         = {2010},
}