Document Detail

Detection and Quantification of Myocardial Reperfusion Hemorrhage Using T2*-Weighted CMR.
MedLine Citation:
PMID:  22172784     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVES: The purpose of this study was to validate T2*-weighted cardiac magnetic resonance (T2*-CMR) for the detection and quantification of reperfusion hemorrhage in vivo against an ex vivo gold standard, and to investigate the relationship of hemorrhage to microvascular obstruction, infarct size, and left ventricular (LV) functional parameters.
BACKGROUND: Hemorrhage can contribute to reperfusion injury in myocardial infarction and may have significant implications for patient management. There is currently no validated imaging method to assess reperfusion hemorrhage in vivo. T2*-CMR appears suitable because it can create image contrast on the basis of magnetic field effects of hemoglobin degradation products.
METHODS: In 14 mongrel dogs, myocardial infarction was experimentally induced. On day 3 post-reperfusion, an in vivo CMR study was performed including a T2*-weighted gradient-echo imaging sequence for hemorrhage, standard sequences for LV function, and post-contrast sequences for microvascular obstruction and myocardial necrosis. Ex vivo, thioflavin S imaging and triphenyl-tetrazoliumchloride (TTC) staining were performed to assess microvascular obstruction, hemorrhage, and myocardial necrosis. Images were analyzed by blinded observers, and comparative statistics were performed.
RESULTS: Hemorrhage occurred only in the dogs with the largest infarctions and the greatest extent of microvascular obstruction, and it was associated with more compromised LV functional parameters. Of 40 hemorrhagic segments on TTC staining, 37 (92.5%) were positive for hemorrhage on T2*-CMR (kappa = 0.96, p < 0.01 for in vivo/ex vivo segmental agreement). The amount of hemorrhage in 13 affected tissue slices as determined by T2*-CMR in vivo correlated strongly with ex vivo results (20.3 ± 2.3% vs. 17.9 ± 1.6% per slice; Pearson r = 0.91; r(2) = 0.83, p < 0.01 for both). Hemorrhage size was not different between in vivo T2*-CMR and ex vivo TTC (mean difference 2.39 ± 1.43%; p = 0.19).
CONCLUSIONS: T2*-CMR accurately quantified myocardial reperfusion hemorrhage in vivo. Hemorrhage was associated with more severe infarct-related injury.
Andreas Kumar; Jordin D Green; Jane M Sykes; Pinhas Ephrat; Jeffrey J L Carson; Andrea J Mitchell; Gerald Wisenberg; Matthias G Friedrich
Related Documents :
21783184 - Feasibility of quantitative analysis of regional left ventricular function in the post-...
22696514 - Clinical effects of cardiac contractility modulation (ccm) as a treatment for chronic h...
813284 - Reduction in infarct size following experimental coronary occlusion by administration o...
148834 - Effect of myocardial ischemia and nitroglycerin on systolic time intervals in the segme...
17931724 - Does coronary slow flow phenomenon lead to myocardial ischemia?
1258734 - Artifacts in portable electrocardiographic monitoring.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  JACC. Cardiovascular imaging     Volume:  4     ISSN:  1876-7591     ISO Abbreviation:  JACC Cardiovasc Imaging     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101467978     Medline TA:  JACC Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1274-83     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  CMR imaging of edema in myocardial infarction using cine balanced steady-state free precession.
Next Document:  CT for evaluation of myocardial cell therapy in heart failure: a comparison with CMR imaging.