Abstract 3140: Tissue Doppler Imaging in the Evaluation of Transmural Extension of Myocardial Necrosis Following Reperfused ST Elevation Myocardial Infarction: Correlation with Contrast-enhanced MRI
Background: Contrast-enhanced MRI (Ce-MRI) identifies the transmural extent of myocardial necrosis. Tissue Doppler imaging (TDI) quantitatively assess regional myocardial function by measuring systolic strain (SS). Limited data are available on the correlation of the infarct extent by ce-MRI and the corresponding regional systolic function by TDI in patients (pts) with ST-elevation myocardial infarction (STEMI).
Methods: Ce-MRI was performed in 17 pts within 10 days of successful percutaneously reperfused STEMI. All examinations were conducted on 1.5T system (Avanto, Siemens). A multi-slice, breath-hold, segmented inversion-recovery turbo FLASH pulse sequences images were acquired at 15–20 minutes as multiple short-axis views. Regional myocardial function was evaluated in the corresponding delayed-hyperenhanced regions by measuring peak SS by TDI (AplioCV,Toshiba). The 17-segments model was applied to correlate the areas of delayed hyperenhancement(DH) with the corresponding SS values. DH was calculated as percentage of wall thickness.
Results: Mean ejection fraction in the population was 39,1±8,8%. 53 segments with DH were studied by TDI and mean SS was −12,4±5,2%. The extent of DH ranged from 45% to 100% of wall thickness. A significant inverse correlation between SS and the extent of DH (r = −0.69) was observed as illustrated in the figure⇓.
Conclusions: Abnormal values of SS were observed in myocardial segments with DH. The significant inverse correlation between the transmurality of myocardial necrosis and SS may represent an important predictive index of the extension of myocardial transmural necrosis in pts with successful percutaneusly reperfused STEMI