Document Detail

Quantification of myocardial area at risk with T2-weighted CMR: comparison with contrast-enhanced CMR and coronary angiography.
MedLine Citation:
PMID:  19608131     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We sought to quantify the myocardium at risk in reperfused acute myocardial infarction (AMI) in man with T2-weighted (T2W) cardiac magnetic resonance (CMR). BACKGROUND: The myocardial area at risk (AAR) is defined as the myocardial tissue within the perfusion bed distally to the culprit lesion of the infarct-related coronary artery. T2W CMR is appealing to retrospectively determine the myocardial AAR after reperfused AMI. Data on the utility of this technique in humans are limited. METHODS: One hundred eight patients with successfully reperfused ST-segment elevation AMI were studied between 1 and 20 days after percutaneous coronary intervention (PCI). We compared the volume of hyperintense myocardium on T2W CMR with the myocardial AAR determined by contrast-enhanced CMR with infarct endocardial surface length (ESL) and AAR estimated by conventional coronary angiography with the BARI (Bypass Angioplasty Revascularization Investigation) risk score. RESULTS: The volume of hyperintense myocardium on T2W CMR (mean 32 +/- 16%, range 3% to 67%) was consistently larger than the volume of myocardial infarction measured with contrast-enhanced images (mean 17 +/- 12%, range 0% to 55%) (p < 0.001). Myocardial salvage ranged from -4% to 45% of the left ventricular myocardium (mean 14 +/- 10%). The AAR determined by T2W CMR compared favorably with the infarct ESL (r = 0.77) with contrast-enhanced CMR, and there was moderate correlation between the BARI angiographic risk score and infarct ESL (r = 0.42). The time between PCI and CMR did not cause a significant difference in the volume of T2W hyperintense myocardium (r = 0.11, p = 0.27) or the calculated volume of salvaged myocardium (r = 0.12, p = 0.23). CONCLUSIONS: T2W CMR performed early after successfully reperfused AMI in humans enables retrospective quantification of the myocardial AAR and salvaged myocardium.
Jeremy Wright; Tom Adriaenssens; Steven Dymarkowski; Walter Desmet; Jan Bogaert
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  JACC. Cardiovascular imaging     Volume:  2     ISSN:  1876-7591     ISO Abbreviation:  JACC Cardiovasc Imaging     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-17     Completed Date:  2009-09-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101467978     Medline TA:  JACC Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  825-31     Citation Subset:  IM    
Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary*
Contrast Media / diagnostic use*
Coronary Angiography*
Edema, Cardiac / diagnosis*,  pathology,  radiography
Gadolinium DTPA / diagnostic use*
Imaging, Three-Dimensional
Magnetic Resonance Imaging*
Middle Aged
Myocardial Infarction / diagnosis*,  pathology,  radiography,  therapy
Myocardium / pathology*
Predictive Value of Tests
Prospective Studies
Risk Assessment
Severity of Illness Index
Time Factors
Treatment Outcome
Reg. No./Substance:
0/Contrast Media; 80529-93-7/Gadolinium DTPA
Comment In:
JACC Cardiovasc Imaging. 2009 Jul;2(7):832-4   [PMID:  19608132 ]

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