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(Circulation. 2006;113:1821-1823.)
© 2006 American Heart Association, Inc.

Editorial

Myocardial Salvage

Retrospection, Resolution, and Radio Waves

Dudley Pennell, MD, FRCP

From the Department Cardiology, National Heart and Lung Institute, Imperial College, London, UK.

Correspondence to Dr Dudley Pennell, Director, Cardiovascular MR Unit, Royal Brompton Hospital, Sydney St, London SW3 6NP, UK. E-mail d.pennell@ic.ac.uk

Key Words: Editorials • magnetic resonance imaging • myocardial infarction • myocardial salvage

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Cardiovascular magnetic resonance (CMR) is established as a major technique in clinical cardiology.¹ An ongoing pipeline of new clinical indications is being fed from clinical and basic research that is throwing new light on pathophysiology of cardiovascular disease and solving clinical problems. One such advance in the last 5 years has been the clinical uptake of late-gadolinium-enhancement CMR, which yields exquisite high-resolution imaging of infarction in the necrotic (acute) or scarred (chronic) phase,² making CMR the clinical gold standard technique for assessing infarct size³ and valuable for assessing potential regional functional recovery (viability).⁴ In this issue, Aletras et al⁵ indicate that CMR also may be used to measure myocardial salvage during acute infarction.

Article p 1865

Myocardial salvage is defined as the difference between the actual and potential infarct size, the latter defined as the initial area at risk during acute coronary occlusion. It is an important concept because its measurement can be used to determine strategies to optimize management of acute myocardial infarction (MI) based on the idea that eventual clinical outcome is related to the size of infarction and that minimization is therefore beneficial. Clinical trials of minimization of infarction have a long and distinguished pedigree.⁶ Myocardial salvage can be measured in several ways, but some are applicable to individuals and others only to groups of patients. Thus, an intervention in acute MI can be tested for benefit by randomization of a cohort of patients to intervention or not, with follow-up of final infarct size surrogates such as . . . [Full Text of this Article]

Related Article:

Retrospective Determination of the Area at Risk for Reperfused Acute Myocardial Infarction With T2-Weighted Cardiac Magnetic Resonance Imaging: Histopathological and Displacement Encoding With Stimulated Echoes (DENSE) Functional Validations

Anthony H. Aletras, Gauri S. Tilak, Alex Natanzon, Li-Yueh Hsu, Felix M. Gonzalez, Robert F. Hoyt, Jr, and Andrew E. Arai
Circulation 2006 113: 1865-1870. [Abstract] [Full Text]

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