Myocardium at risk after acute infarction in humans on cardiac magnetic resonance: quantitative assessment during follow-up and validation with single-photon emission computed tomography.

Carlsson, Marcus; Ubachs, Joey; Hedström, Erik; Heiberg, Einar; Jovinge, Stefan; Arheden, Håkan

Myocardium at risk after acute infarction in humans on cardiac magnetic resonance: quantitative assessment during follow-up and validation with single-photon emission computed tomography.

Mark

Carlsson, Marcus ^LU ; Ubachs, Joey ^LU ; Hedström, Erik ^LU

; Heiberg, Einar ^LU ; Jovinge, Stefan ^LU and Arheden, Håkan ^LU (2009) In JACC: Cardiovascular Imaging 2(5). p.569-576

Abstract: OBJECTIVES: Our goal was to validate myocardium at risk on T2-weighted short tau inversion recovery (T2-STIR) cardiac magnetic resonance (CMR) over time, compared with that seen with perfusion single-photon emission computed tomography (SPECT) in patients with ST-segment elevation myocardial infarction, and to assess the amount of salvaged myocardium after 1 week. BACKGROUND: To assess reperfusion therapy, it is necessary to determine how much myocardium is salvaged by measuring the final infarct size in relation to the initial myocardium at risk of the left ventricle (LV). METHODS: Sixteen patients with first-time ST-segment elevation myocardial infarction received (99m)Tc tetrofosmin before primary percutaneous coronary intervention.... (More); OBJECTIVES: Our goal was to validate myocardium at risk on T2-weighted short tau inversion recovery (T2-STIR) cardiac magnetic resonance (CMR) over time, compared with that seen with perfusion single-photon emission computed tomography (SPECT) in patients with ST-segment elevation myocardial infarction, and to assess the amount of salvaged myocardium after 1 week. BACKGROUND: To assess reperfusion therapy, it is necessary to determine how much myocardium is salvaged by measuring the final infarct size in relation to the initial myocardium at risk of the left ventricle (LV). METHODS: Sixteen patients with first-time ST-segment elevation myocardial infarction received (99m)Tc tetrofosmin before primary percutaneous coronary intervention. SPECT was performed within 4 h and T2-STIR CMR within 1 day, 1 week, 6 weeks, and 6 months. At 1 week, patients were injected with a gadolinium-based contrast agent for quantification of infarct size. RESULTS: Myocardium at risk at occlusion on SPECT was 33 +/- 10% of the LV. Myocardium at risk on T2-STIR did not differ from SPECT, at day 1 (29 +/- 7%, p = 0.49) or week 1 (31 +/- 6%, p = 0.16) but declined at week 6 (10 +/- 12%, p = 0.0096 vs. 1 week) and month 6 (4 +/- 11%, p = 0.0013 vs. 1 week). There was a correlation between myocardium at risk demonstrated by T2-STIR at week 1 and myocardium at risk by SPECT (r(2) = 0.70, p < 0.001), and the difference between the methods on Bland-Altman analysis was not significant (-2.3 +/- 5.7%, p = 0.16). Both modalities identified myocardium at risk in the same perfusion territory and in concordance with angiography. Final infarct size was 8 +/- 7%, and salvage was 75 +/- 19% of myocardium at risk. CONCLUSIONS: This study demonstrates that T2-STIR performed up to 1 week after reperfusion can accurately determine myocardium at risk as it was before opening of the occluded artery. CMR can also quantify salvaged myocardium as myocardium at risk minus final infarct size. (Less)

Please use this url to cite or link to this publication: https://lup.lub.lu.se/record/1412271

author

Carlsson, Marcus ^LU ; Ubachs, Joey ^LU ; Hedström, Erik ^LU

; Heiberg, Einar ^LU ; Jovinge, Stefan ^LU and Arheden, Håkan ^LU

organization

publishing date

2009

type

Contribution to journal

publication status

published

subject

in

JACC: Cardiovascular Imaging

volume

2

issue

5

pages

569 - 576

publisher

Elsevier

external identifiers

wos:000287653200007
pmid:19442942
scopus:65549119248

ISSN

1876-7591

DOI

10.1016/j.jcmg.2008.11.018

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), Department of Clinical Physiology (Lund) (013013000)

id

1c3d9c34-b997-4587-865e-7adfbae1dae6 (old id 1412271)

alternative location

http://www.ncbi.nlm.nih.gov/pubmed/19442942?dopt=Abstract

date added to LUP

2016-04-01 12:10:20

date last changed

2023-03-01 17:47:03

@article{1c3d9c34-b997-4587-865e-7adfbae1dae6,
  abstract     = {{OBJECTIVES: Our goal was to validate myocardium at risk on T2-weighted short tau inversion recovery (T2-STIR) cardiac magnetic resonance (CMR) over time, compared with that seen with perfusion single-photon emission computed tomography (SPECT) in patients with ST-segment elevation myocardial infarction, and to assess the amount of salvaged myocardium after 1 week. BACKGROUND: To assess reperfusion therapy, it is necessary to determine how much myocardium is salvaged by measuring the final infarct size in relation to the initial myocardium at risk of the left ventricle (LV). METHODS: Sixteen patients with first-time ST-segment elevation myocardial infarction received (99m)Tc tetrofosmin before primary percutaneous coronary intervention. SPECT was performed within 4 h and T2-STIR CMR within 1 day, 1 week, 6 weeks, and 6 months. At 1 week, patients were injected with a gadolinium-based contrast agent for quantification of infarct size. RESULTS: Myocardium at risk at occlusion on SPECT was 33 +/- 10% of the LV. Myocardium at risk on T2-STIR did not differ from SPECT, at day 1 (29 +/- 7%, p = 0.49) or week 1 (31 +/- 6%, p = 0.16) but declined at week 6 (10 +/- 12%, p = 0.0096 vs. 1 week) and month 6 (4 +/- 11%, p = 0.0013 vs. 1 week). There was a correlation between myocardium at risk demonstrated by T2-STIR at week 1 and myocardium at risk by SPECT (r(2) = 0.70, p &lt; 0.001), and the difference between the methods on Bland-Altman analysis was not significant (-2.3 +/- 5.7%, p = 0.16). Both modalities identified myocardium at risk in the same perfusion territory and in concordance with angiography. Final infarct size was 8 +/- 7%, and salvage was 75 +/- 19% of myocardium at risk. CONCLUSIONS: This study demonstrates that T2-STIR performed up to 1 week after reperfusion can accurately determine myocardium at risk as it was before opening of the occluded artery. CMR can also quantify salvaged myocardium as myocardium at risk minus final infarct size.}},
  author       = {{Carlsson, Marcus and Ubachs, Joey and Hedström, Erik and Heiberg, Einar and Jovinge, Stefan and Arheden, Håkan}},
  issn         = {{1876-7591}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{569--576}},
  publisher    = {{Elsevier}},
  series       = {{JACC: Cardiovascular Imaging}},
  title        = {{Myocardium at risk after acute infarction in humans on cardiac magnetic resonance: quantitative assessment during follow-up and validation with single-photon emission computed tomography.}},
  url          = {{https://lup.lub.lu.se/search/files/2811631/1458641.pdf}},
  doi          = {{10.1016/j.jcmg.2008.11.018}},
  volume       = {{2}},
  year         = {{2009}},
}

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Myocardium at risk after acute infarction in humans on cardiac magnetic resonance: quantitative assessment during follow-up and validation with single-photon emission computed tomography.