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Evolution of reperfusion post-infarction ventricular remodeling: New MRI insights.
MedLine Citation:
PMID:  24182681     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Our current understanding is that left ventricular (LV) remodeling after acute myocardial infarction (AMI) is caused by expansion of the infarcted myocardium with thinning of the wall and eccentric hypertrophy of the remote myocardium. To study the geometric changes in the remodeling process after reperfused AMI we used cardiac magnetic resonance imaging (CMR).
METHODS: Nine juvenile swine underwent a 120-min occlusion of the left circumflex coronary artery followed by reperfusion. CMR was performed at 3 and 36days post-infarction. Global and regional LV remodeling was assessed including geometric changes of infarcted and remote myocardium; infarct longitudinal length (mm), mean circumferential length (mm), total infarct surface (mm(2)), end-diastolic wall thickness (EDWT) (mm) and transmural extent of infarction (TEI).
RESULTS: From 3days to 36days post-infarction end-diastolic volume increased by 43% (p<0.01). Infarct mass decreased by 36% (p<0.01), mainly by reduction of EDWT with 26%, while mean infarct circumferential length and longitudinal infarct length did not change. Remote myocardial mass increased by 23%, which was the result of an increase in its circumferential length from 95±10mm to 113±11mm (p<0.01), with no change in its EDWT. In contrast, EDWT in the infarct, peri-infarct and border zone decreased.
CONCLUSIONS: Contrary to the widely held view the present, using CMR measurements, shows that post-infarction remodeling was not associated with expansion of the infarcted myocardium. These findings suggest that eccentric hypertrophy of the remote myocardium, but not expansion of the infarct region, is responsible for left ventricular dilatation after AMI.
Authors:
Tirza Springeling; André Uitterdijk; Alexia Rossi; Charlotte Gorsse-Bakker; Piotr A Wielopolski; Willem J van der Giessen; Gabriel P Krestin; Pim J de Feyter; Dirk J Duncker; Robert-Jan M van Geuns
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-10-6
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-11-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013.
Affiliation:
Erasmus Medical Centre, Department of Cardiology, Rotterdam, The Netherlands; Erasmus Medical Centre, Department of Radiology, Rotterdam, The Netherlands.
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