on April 10, 2006
Published online before print April 10, 2006, doi: 10.1161/CIRCULATIONAHA.105.576025
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Submitted on July 14, 2005
From the National Heart, Lung and Blood Institute, National Institutes of Heath, US Department of Health and Human Services, Bethesda, Md (A.H.A., G.S.T., A.N., L.-Y.H., F.M.G., R.F.H., A.E.A.); and Mount Sinai School of Medicine, New York, NY (A.N.). * To whom correspondence should be addressed. E-mail: AraiA{at}nhlbi.nih.gov.
Background--The aim of this study was to determine whether edema imaging by T2-weighted cardiac magnetic resonance (CMR) imaging could retrospectively delineate the area at risk in reperfused myocardial infarction. We hypothesized that the size of the area at risk during a transient occlusion would be similar to the T2-weighted hyperintense region observed 2 days later, that the T2-weighted hyperintense myocardium would show partial functional recovery after 2 months, and that the T2 abnormality would resolve over 2 months. Methods and Results--Seventeen dogs underwent a 90-minute coronary artery occlusion, followed by reperfusion. The area at risk, as measured with microspheres (9 animals), was comparable to the size of the hyperintense zone on T2-weighted images 2 days later (43.4±3.3% versus 43.0±3.4% of the left ventricle; P=NS), and the 2 measures correlated (R=0.84). The infarcted zone was significantly smaller (23.1±3.7; both P<0.001). To test whether the hyperintense myocardium would exhibit partial functional recovery over time, 8 animals were imaged on day 2 and 2 months later. Systolic strain was mapped with displacement encoding with stimulated echoes. Edema, as detected by a hyperintense zone on T2-weighted images, resolved, and regional radial systolic strain partially improved from 4.9±0.7 to 13.1±1.5 (P=0.001) over 2 months. Conclusions--These findings are consistent with the premise that the T2 abnormality depicts the area at risk, a zone of reversibly and irreversibly injured myocardium associated with reperfused subendocardial infarctions. The persistence of postischemic edema allows T2-weighted CMR to delineate the area at risk 2 days after reperfused myocardial infarction.
Revised on January 27, 2006
Accepted on February 1, 2006
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 PhD,
Key words: contractility • edema • magnetic resonance imaging • myocardial infarction • myocardial strain
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