Document Detail


Serial contrast-enhanced cardiac magnetic resonance imaging demonstrates regression of hyperenhancement within the coronary artery wall in patients after acute myocardial infarction.
MedLine Citation:
PMID:  19442944     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Our aim was to determine whether serial contrast-enhanced cardiac magnetic resonance (CE-CMR) is useful for the characterization of tissue signal changes within the coronary vessel wall in patients after acute myocardial infarction (AMI). BACKGROUND: Inflammation plays a key role in the development of AMI. CE-CMR of the vessel wall has been found useful for the characterization of inflammatory tissue signal changes in patients with carotid artery stenosis, giant cell arteritis, or Takayasu's arteritis; however, it has never been serially performed in the coronary artery wall in patients with acute and chronic myocardial infarction using a gadolinium-based contrast medium and compared with systemic markers of inflammation. METHODS: CE-CMR using a T1-weighted 3-dimensional gradient echo inversion recovery sequence of the coronary artery wall and 0.2 mmol/kg of gadolinium-diethylenetriaminepentaacetic acid was performed in 10 patients with AMI 6 days and 3 months after coronary intervention and in 9 subjects without coronary artery disease on invasive coronary angiography. Contrast-to-noise ratio (CNR) within the coronary artery wall was quantified in comparison with blood signal. RESULTS: Patients with AMI demonstrated a significantly increased coronary vessel wall enhancement 6 days after infarction compared with normal subjects (CNR 7.8 +/- 4.4 vs. 5.3 +/- 3.2, p < 0.001). Three months after infarction, CNR decreased to 6.5 +/- 4.7 (p < 0.03). This decrease paralleled declines in C-reactive protein. Angiographically normal segments showed no contrast changes, but CNR significantly decreased in stenotic segments, from 10.9 +/- 3.8 to 6.8 +/- 5.0 (p < 0.002), resulting in a reduction of enhanced segments from 70% to 25% (p < 0.01). CONCLUSIONS: Serial CE-CMR identified changes in spatial extent and intensity of coronary contrast enhancement in patients after AMI. This technique may be useful for the characterization of transient coronary tissue signal changes, which may represent edema or inflammation during the post-infarction phase. In addition, CE-CMR may offer the potential for visualization of inflammatory activity in atherosclerosis associated with acute coronary syndromes.
Authors:
Tareq Ibrahim; Markus R Makowski; Antanas Jankauskas; David Maintz; Martin Karch; Sylvia Schachoff; Warren J Manning; Albert Schömig; Markus Schwaiger; Rene M Botnar
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  JACC. Cardiovascular imaging     Volume:  2     ISSN:  1876-7591     ISO Abbreviation:  JACC Cardiovasc Imaging     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-15     Completed Date:  2009-07-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101467978     Medline TA:  JACC Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  580-8     Citation Subset:  IM    
Affiliation:
Deutsches Herzzentrum München and 1. Medizinische Klinik des Klinikums Rechts der Isar, Technische Universität München, München, Germany.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary* / instrumentation
C-Reactive Protein / metabolism
Case-Control Studies
Contrast Media / diagnostic use*
Coronary Angiography
Coronary Stenosis / complications,  immunology,  pathology*,  therapy
Coronary Vessels / immunology,  pathology*
Drug-Eluting Stents
Female
Gadolinium DTPA / diagnostic use*
Humans
Inflammation / complications,  immunology,  pathology*
Inflammation Mediators / metabolism
Magnetic Resonance Angiography*
Male
Middle Aged
Myocardial Infarction / etiology,  immunology,  pathology*,  therapy
Predictive Value of Tests
Prospective Studies
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Inflammation Mediators; 80529-93-7/Gadolinium DTPA; 9007-41-4/C-Reactive Protein
Comments/Corrections
Comment In:
JACC Cardiovasc Imaging. 2009 May;2(5):589-91   [PMID:  19442945 ]

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