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Experimental validation of contrast-enhanced SSFP cine CMR for quantification of myocardium at risk in acute myocardial infarction

Nordlund, David LU ; Kanski, Mikael LU ; Jablonowski, Robert LU ; Koul, Sasha LU ; Erlinge, David LU ; Carlsson, Marcus LU ; Engblom, Henrik LU ; Aletras, Anthony H. LU and Arheden, Håkan LU (2017) In Journal of Cardiovascular Magnetic Resonance 19(1).
Abstract

Background: Accurate assessment of myocardium at risk (MaR) after acute myocardial infarction (AMI) is necessary when assessing myocardial salvage. Contrast-enhanced steady-state free precession (CE-SSFP) is a recently developed cardiovascular magnetic resonance (CMR) method for assessment of MaR up to 1 week after AMI. Our aim was to validate CE-SSFP for determination of MaR in an experimental porcine model using myocardial perfusion single-photon emission computed tomography (MPS) as a reference standard and to test the stability of MaR-quantification over time after injecting gadolinium-based contrast. Methods: Eleven pigs were subjected to either 35 or 40 min occlusion of the left anterior descending artery followed by six hours of... (More)

Background: Accurate assessment of myocardium at risk (MaR) after acute myocardial infarction (AMI) is necessary when assessing myocardial salvage. Contrast-enhanced steady-state free precession (CE-SSFP) is a recently developed cardiovascular magnetic resonance (CMR) method for assessment of MaR up to 1 week after AMI. Our aim was to validate CE-SSFP for determination of MaR in an experimental porcine model using myocardial perfusion single-photon emission computed tomography (MPS) as a reference standard and to test the stability of MaR-quantification over time after injecting gadolinium-based contrast. Methods: Eleven pigs were subjected to either 35 or 40 min occlusion of the left anterior descending artery followed by six hours of reperfusion. A technetium-based perfusion tracer was administered intravenously ten minutes before reperfusion. In-vivo and ex-vivo CE-SSFP CMR was performed followed by ex-vivo MPS imaging. MaR was expressed as % of left ventricular mass (LVM). Results: There was good agreement between MaR by ex-vivo CMR and MaR by MPS (bias: 1 ± 3% LVM, r 2 = 0.92, p < 0.001), between ex-vivo and in-vivo CMR (bias 0 ± 2% LVM, r 2 = 0.94, p < 0.001) and between in-vivo CMR and MPS (bias -2 ± 3% LVM, r 2 = 0.87, p < 0.001. No change in MaR was seen over the first 30 min after contrast injection (p = 0.95). Conclusions: Contrast-enhanced SSFP cine CMR can be used to measure MaR, both in vivo and ex vivo, in a porcine model with good accuracy and precision over the first 30 min after contrast injection. This offers the option to use the less complex ex-vivo imaging when determining myocardial salvage in experimental studies.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
AAR, Area at risk, CE-SSFP, Myocardium at risk
in
Journal of Cardiovascular Magnetic Resonance
volume
19
issue
1
publisher
BioMed Central
external identifiers
  • scopus:85010953286
  • wos:000392985000001
ISSN
1097-6647
DOI
10.1186/s12968-017-0325-y
language
English
LU publication?
yes
id
5b8d9e3c-11ac-4b43-8595-d60c3d4e1198
date added to LUP
2017-02-14 13:22:51
date last changed
2018-01-07 11:49:36
@article{5b8d9e3c-11ac-4b43-8595-d60c3d4e1198,
  abstract     = {<p>Background: Accurate assessment of myocardium at risk (MaR) after acute myocardial infarction (AMI) is necessary when assessing myocardial salvage. Contrast-enhanced steady-state free precession (CE-SSFP) is a recently developed cardiovascular magnetic resonance (CMR) method for assessment of MaR up to 1 week after AMI. Our aim was to validate CE-SSFP for determination of MaR in an experimental porcine model using myocardial perfusion single-photon emission computed tomography (MPS) as a reference standard and to test the stability of MaR-quantification over time after injecting gadolinium-based contrast. Methods: Eleven pigs were subjected to either 35 or 40 min occlusion of the left anterior descending artery followed by six hours of reperfusion. A technetium-based perfusion tracer was administered intravenously ten minutes before reperfusion. In-vivo and ex-vivo CE-SSFP CMR was performed followed by ex-vivo MPS imaging. MaR was expressed as % of left ventricular mass (LVM). Results: There was good agreement between MaR by ex-vivo CMR and MaR by MPS (bias: 1 ± 3% LVM, r <sup>2</sup> = 0.92, p &lt; 0.001), between ex-vivo and in-vivo CMR (bias 0 ± 2% LVM, r <sup>2</sup> = 0.94, p &lt; 0.001) and between in-vivo CMR and MPS (bias -2 ± 3% LVM, r <sup>2</sup> = 0.87, p &lt; 0.001. No change in MaR was seen over the first 30 min after contrast injection (p = 0.95). Conclusions: Contrast-enhanced SSFP cine CMR can be used to measure MaR, both in vivo and ex vivo, in a porcine model with good accuracy and precision over the first 30 min after contrast injection. This offers the option to use the less complex ex-vivo imaging when determining myocardial salvage in experimental studies.</p>},
  articleno    = {12},
  author       = {Nordlund, David and Kanski, Mikael and Jablonowski, Robert and Koul, Sasha and Erlinge, David and Carlsson, Marcus and Engblom, Henrik and Aletras, Anthony H. and Arheden, Håkan},
  issn         = {1097-6647},
  keyword      = {AAR,Area at risk,CE-SSFP,Myocardium at risk},
  language     = {eng},
  month        = {01},
  number       = {1},
  publisher    = {BioMed Central},
  series       = {Journal of Cardiovascular Magnetic Resonance},
  title        = {Experimental validation of contrast-enhanced SSFP cine CMR for quantification of myocardium at risk in acute myocardial infarction},
  url          = {http://dx.doi.org/10.1186/s12968-017-0325-y},
  volume       = {19},
  year         = {2017},
}