Document Detail


Myocardial edema as detected by pre-contrast T1 and T2 CMR delineates area at risk associated with acute myocardial infarction.
MedLine Citation:
PMID:  22698528     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to determine whether cardiac magnetic resonance (CMR) in vivo T1 mapping can measure myocardial area at risk (AAR) compared with microspheres or T2 mapping CMR.
BACKGROUND: If T2-weighted CMR is abnormal in the AAR due to edema related to myocardial ischemia, then T1-weighted CMR should also be able to detect and accurately quantify AAR.
METHODS: Dogs (n = 9) underwent a 2-h coronary occlusion followed by 4 h of reperfusion. CMR of the left ventricle was performed for mapping of T1 and T2 prior to any contrast administration. AAR was defined as regions that had a T1 or T2 value (ms) >2 SD from remote myocardium, and regions with microsphere blood flow (ml/min/g) during occlusion <2 SD from remote myocardium. Infarct size was determined by triphenyltetrazolium chloride staining.
RESULTS: The relaxation parameters T1 and T2 were increased in the AAR compared with remote myocardium (mean ± SD: T1, 1,133 ± 55 ms vs. 915 ± 33 ms; T2, 71 ± 6 ms vs. 49 ± 3 ms). On a slice-by-slice basis (n = 78 slices), AAR by T1 and T2 mapping correlated (R(2) = 0.95, p < 0.001) with good agreement (mean ± 2 SD: 0.4 ± 16.6% of slice). On a whole-heart analysis, T1 measurements of left ventricular mass, AAR, and myocardial salvage correlated to microsphere measures (R(2) = 0.94) with good agreement (mean ± 2 SD: -1.4 ± 11.2 g of myocardium). Corresponding T2 measurements of left ventricular mass, AAR, and salvage correlated to microsphere analysis (R(2) = 0.96; mean ± 2 SD: agreement 1.6 ± 9.2 g of myocardium). This yielded a median infarct size of 30% of the AAR (range 12% to 52% of AAR).
CONCLUSIONS: For determining AAR after acute myocardial infarction, noncontrast T1 mapping and T2 mapping sequences yield similar quantitative results, and both agree well with microspheres. The relaxation properties T1 and T2 both change in a way that is consistent with the presence of myocardial edema following myocardial ischemia/reperfusion.
Authors:
Martin Ugander; Paul S Bagi; Abiola J Oki; Billy Chen; Li-Yueh Hsu; Anthony H Aletras; Saurabh Shah; Andreas Greiser; Peter Kellman; Andrew E Arai
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, N.I.H., Intramural    
Journal Detail:
Title:  JACC. Cardiovascular imaging     Volume:  5     ISSN:  1876-7591     ISO Abbreviation:  JACC Cardiovasc Imaging     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-06-15     Completed Date:  2012-10-29     Revised Date:  2013-09-12    
Medline Journal Info:
Nlm Unique ID:  101467978     Medline TA:  JACC Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  596-603     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Coronary Circulation
Disease Models, Animal
Dogs
Edema, Cardiac / diagnosis*,  pathology
Fluorescent Dyes / diagnostic use
Image Interpretation, Computer-Assisted
Magnetic Resonance Imaging*
Microcirculation
Microspheres
Myocardial Infarction / diagnosis*,  pathology,  physiopathology
Myocardial Perfusion Imaging
Myocardium / pathology*
Observer Variation
Predictive Value of Tests
Reproducibility of Results
Grant Support
ID/Acronym/Agency:
1 Z01 HL004607-08 CE/CE/NCIPC CDC HHS; HL-CR-05-004/HL/NHLBI NIH HHS; ZIA HL004607-14/HL/NHLBI NIH HHS; ZIA HL006136-01/HL/NHLBI NIH HHS; ZIA HL006136-02/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Fluorescent Dyes
Comments/Corrections
Comment In:
JACC Cardiovasc Imaging. 2012 Jun;5(6):604-6   [PMID:  22698529 ]

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