Advanced

Extent of myocardium at risk for left anterior descending artery, right coronary artery, and left circumflex artery occlusion depicted by contrast-enhanced steady state free precession and T2-weighted short tau inversion recovery magnetic resonance imaging

Nordlund, David LU ; Heiberg, Einar LU ; Carlsson, Marcus LU ; Fründ, Ernst Torben; Hoffmann, Pavel; Koul, Sasha LU ; Atar, Dan; Aletras, Anthony H. LU ; Erlinge, David LU and Engblom, Henrik LU , et al. (2016) In Circulation Cardiovascular Imaging 9(7).
Abstract

Background - Contrast-enhanced steady state free precession (CE-SSFP) and T2-weighted short tau inversion recovery (T2-STIR) have been clinically validated to estimate myocardium at risk (MaR) by cardiovascular magnetic resonance while using myocardial perfusion single-photon emission computed tomography as reference standard. Myocardial perfusion single-photon emission computed tomography has been used to describe the coronary perfusion territories during myocardial ischemia. Compared with myocardial perfusion single-photon emission computed tomography, cardiovascular magnetic resonance offers superior image quality and practical advantages. Therefore, the aim was to describe the main coronary perfusion territories using CE-SSFP and... (More)

Background - Contrast-enhanced steady state free precession (CE-SSFP) and T2-weighted short tau inversion recovery (T2-STIR) have been clinically validated to estimate myocardium at risk (MaR) by cardiovascular magnetic resonance while using myocardial perfusion single-photon emission computed tomography as reference standard. Myocardial perfusion single-photon emission computed tomography has been used to describe the coronary perfusion territories during myocardial ischemia. Compared with myocardial perfusion single-photon emission computed tomography, cardiovascular magnetic resonance offers superior image quality and practical advantages. Therefore, the aim was to describe the main coronary perfusion territories using CE-SSFP and T2-STIR cardiovascular magnetic resonance data in patients after acute ST-segment-elevation myocardial infarction. Methods and Results - CE-SSFP and T2-STIR data from 2 recent multicenter trials, CHILL-MI and MITOCARE (n=215), were used to assess MaR. Angiography was used to determine culprit vessel. Of 215 patients, 39% had left anterior descending artery occlusion, 49% had right coronary artery occlusion, and 12% had left circumflex artery occlusion. Mean extent of MaR using CE-SSFP was 44±10% for left anterior descending artery, 31±7% for right coronary artery, and 30±9% for left circumflex artery. Using T2-STIR, MaR was 44±9% for left anterior descending artery, 30±8% for right coronary artery, and 30±12% for left circumflex artery. MaR was visualized in polar plots, and expected overlap was found between right coronary artery and left circumflex artery. Detailed regional data are presented for use in software algorithms as a priori information on the extent of MaR. Conclusions - For the first time, cardiovascular magnetic resonance has been used to show the main coronary perfusion territories using CE-SSFP and T2-STIR. The good agreement between CE-SSFP and T2-STIR from this study and myocardial perfusion single-photon emission computed tomography from previous studies indicates that these 3 methods depict MaR accurately in individual patients and at a group level. Clinical Trial Registration - URL: http://www.clinicaltrials.gov. Unique identifiers: NCT01379261 and NCT01374321.

(Less)
Please use this url to cite or link to this publication:
author
, et al. (More)
(Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
coronary occlusion, coronary vessels, magnetic resonance imaging, myocardial ischemia, myocardium
in
Circulation Cardiovascular Imaging
volume
9
issue
7
publisher
Lippincott Williams & Wilkins
external identifiers
  • Scopus:84979010076
  • WOS:000380608900002
ISSN
1941-9651
DOI
10.1161/CIRCIMAGING.115.004376
language
English
LU publication?
yes
id
a1fb1ef5-3038-44ea-ab27-5555c65ce83e
date added to LUP
2016-08-19 14:33:56
date last changed
2017-01-01 08:32:23
@article{a1fb1ef5-3038-44ea-ab27-5555c65ce83e,
  abstract     = {<p>Background - Contrast-enhanced steady state free precession (CE-SSFP) and T2-weighted short tau inversion recovery (T2-STIR) have been clinically validated to estimate myocardium at risk (MaR) by cardiovascular magnetic resonance while using myocardial perfusion single-photon emission computed tomography as reference standard. Myocardial perfusion single-photon emission computed tomography has been used to describe the coronary perfusion territories during myocardial ischemia. Compared with myocardial perfusion single-photon emission computed tomography, cardiovascular magnetic resonance offers superior image quality and practical advantages. Therefore, the aim was to describe the main coronary perfusion territories using CE-SSFP and T2-STIR cardiovascular magnetic resonance data in patients after acute ST-segment-elevation myocardial infarction. Methods and Results - CE-SSFP and T2-STIR data from 2 recent multicenter trials, CHILL-MI and MITOCARE (n=215), were used to assess MaR. Angiography was used to determine culprit vessel. Of 215 patients, 39% had left anterior descending artery occlusion, 49% had right coronary artery occlusion, and 12% had left circumflex artery occlusion. Mean extent of MaR using CE-SSFP was 44±10% for left anterior descending artery, 31±7% for right coronary artery, and 30±9% for left circumflex artery. Using T2-STIR, MaR was 44±9% for left anterior descending artery, 30±8% for right coronary artery, and 30±12% for left circumflex artery. MaR was visualized in polar plots, and expected overlap was found between right coronary artery and left circumflex artery. Detailed regional data are presented for use in software algorithms as a priori information on the extent of MaR. Conclusions - For the first time, cardiovascular magnetic resonance has been used to show the main coronary perfusion territories using CE-SSFP and T2-STIR. The good agreement between CE-SSFP and T2-STIR from this study and myocardial perfusion single-photon emission computed tomography from previous studies indicates that these 3 methods depict MaR accurately in individual patients and at a group level. Clinical Trial Registration - URL: http://www.clinicaltrials.gov. Unique identifiers: NCT01379261 and NCT01374321.</p>},
  author       = {Nordlund, David and Heiberg, Einar and Carlsson, Marcus and Fründ, Ernst Torben and Hoffmann, Pavel and Koul, Sasha and Atar, Dan and Aletras, Anthony H. and Erlinge, David and Engblom, Henrik and Arheden, Håkan},
  issn         = {1941-9651},
  keyword      = {coronary occlusion,coronary vessels,magnetic resonance imaging,myocardial ischemia,myocardium},
  language     = {eng},
  month        = {07},
  number       = {7},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Circulation Cardiovascular Imaging},
  title        = {Extent of myocardium at risk for left anterior descending artery, right coronary artery, and left circumflex artery occlusion depicted by contrast-enhanced steady state free precession and T2-weighted short tau inversion recovery magnetic resonance imaging},
  url          = {http://dx.doi.org/10.1161/CIRCIMAGING.115.004376},
  volume       = {9},
  year         = {2016},
}