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Relationship between Myocardial Edema and Regional Myocardial Function after Reperfused Acute Myocardial Infarction: An MR Imaging Study.
MedLine Citation:
PMID:  23382292     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Purpose:To compare the relationship of myocardial edema and corresponding contractile function over time in patients with reperfused acute myocardial infarction (AMI).Materials and Methods:This study was approved by the regional ethics committee; all patients gave written informed consent. Thirty-nine patients (34 men; mean age, 57 years; age range, 35-73 years) underwent T2-weighted, tagging, and late gadolinium enhancement magnetic resonance imaging at three time points after primary percutaneous coronary intervention for ST-elevation AMI. Circumferential strain, T2-weighted signal intensity, and volume of infarct zones, peri-infarct zones, and remote myocardium were measured. Patients were stratified by presence or absence of peri-infarct edema, defined as areas with T2-weighted signal intensity of two or more standard deviations above that of remote myocardium. Statistical analysis was performed with repeated-measures analysis of variance with post hoc Bonferroni correction.Results:Edematous peri-infarct myocardium had attenuated strain compared with remote myocardium at day 2 (-0.137 vs -0.226, P < .001), day 30 (-0.188 vs -0.240, P < .01), and day 90 (-0.207 vs -0.241, P = .01). Nonedematous peri-infarct myocardium had similar (P > .05) strain to remote myocardium at all time points. Strain improved in edematous peri-infarct myocardium at day 30 (P = .02) and day 90 (P < .01), closely mirroring resolution of intensity and volume of edema. Decreased strain correlated with edema volume (r = 0.30, P = .01) and normalized edema signal intensity (r = 0.28, P < .01). In eight patients with fully transmural infarction, infarct zone strain improved between day 2 and day 90 (P = .02).Conclusion:Improvement of strain in peri-infarct myocardium closely follows regression of myocardial edema. Volume of edema and intensity of signal on T2-weighted images relate to functional recovery after reperfused AMI.© RSNA, 2013Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12121516/-/DC1.
Authors:
Ananth Kidambi; Adam N Mather; Peter Swoboda; Manish Motwani; Timothy A Fairbairn; John P Greenwood; Sven Plein
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-4
Journal Detail:
Title:  Radiology     Volume:  -     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Multidisciplinary Cardiovascular Research Centre & Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Great George St, Leeds LS2 9JT, England.
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