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Cardiovascular magnetic resonance by non contrast T1-mapping allows assessment of severity of injury in acute myocardial infarction

Journal of cardiovascular magnetic resonance, 2012-02, Vol.14 (1), p.15-15, Article 15 [Peer Reviewed Journal]

COPYRIGHT 2012 BioMed Central Ltd. ;COPYRIGHT 2012 BioMed Central Ltd. ;2012 Dall'Armellina et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. ;Copyright ©2012 Dall'Armellina et al; licensee BioMed Central Ltd. 2012 Dall'Armellina et al; licensee BioMed Central Ltd. ;ISSN: 1532-429X ;ISSN: 1097-6647 ;EISSN: 1532-429X ;DOI: 10.1186/1532-429x-14-15 ;PMID: 22309452

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Title:
Cardiovascular magnetic resonance by non contrast T1-mapping allows assessment of severity of injury in acute myocardial infarction
Author: Dall'Armellina, Erica ; Piechnik, Stefan K ; Ferreira, Vanessa M ; Si, Quang Le ; Robson, Matthew D ; Francis, Jane M ; Cuculi, Florim ; Kharbanda, Rajesh K ; Banning, Adrian P ; Choudhury, Robin P ; Karamitsos, Theodoros D ; Neubauer, Stefan
Subjects: Analysis of Variance ; Angioplasty, Balloon, Coronary ; Biomedical research ; Cardiology ; Cardiovascular disease ; Chi-Square Distribution ; Clinical medicine ; Contrast Media ; Diagnosis ; Edema, Cardiac - diagnosis ; Edema, Cardiac - pathology ; England ; Female ; Gadolinium ; Gadolinium DTPA ; Health aspects ; Heart attack ; Heart attacks ; Humans ; Ischemia ; Logistic Models ; Magnetic resonance imaging ; Magnetic Resonance Imaging, Cine ; Male ; Methods ; Middle Aged ; Myocardial Infarction - diagnosis ; Myocardial Infarction - pathology ; Myocardial Infarction - physiopathology ; Myocardial Infarction - therapy ; Myocardium - pathology ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Recovery of Function ; ROC Curve ; Severity of Illness Index ; Studies ; Time Factors ; Treatment Outcome
Is Part Of: Journal of cardiovascular magnetic resonance, 2012-02, Vol.14 (1), p.15-15, Article 15
Description: Current cardiovascular magnetic resonance (CMR) methods, such as late gadolinium enhancement (LGE) and oedema imaging (T2W) used to depict myocardial ischemia, have limitations. Novel quantitative T1-mapping techniques have the potential to further characterize the components of ischemic injury. In patients with myocardial infarction (MI) we sought to investigate whether state-of the art pre-contrast T1-mapping (1) detects acute myocardial injury, (2) allows for quantification of the severity of damage when compared to standard techniques such as LGE and T2W, and (3) has the ability to predict long term functional recovery. 3T CMR including T2W, T1-mapping and LGE was performed in 41 patients [of these, 78% were ST elevation MI (STEMI)] with acute MI at 12-48 hour after chest pain onset and at 6 months (6M). Patients with STEMI underwent primary PCI prior to CMR. Assessment of acute regional wall motion abnormalities, acute segmental damaged fraction by T2W and LGE and mean segmental T1 values was performed on matching short axis slices. LGE and improvement in regional wall motion at 6M were also obtained. We found that the variability of T1 measurements was significantly lower compared to T2W and that, while the diagnostic performance of acute T1-mapping for detecting myocardial injury was at least as good as that of T2W-CMR in STEMI patients, it was superior to T2W imaging in NSTEMI. There was a significant relationship between the segmental damaged fraction assessed by either by LGE or T2W, and mean segmental T1 values (P < 0.01). The index of salvaged myocardium derived by acute T1-mapping and 6M LGE was not different to the one derived from T2W (P = 0.88). Furthermore, the likelihood of improvement of segmental function at 6M decreased progressively as acute T1 values increased (P < 0.0004). In acute MI, pre-contrast T1-mapping allows assessment of the extent of myocardial damage. T1-mapping might become an important complementary technique to LGE and T2W for identification of reversible myocardial injury and prediction of functional recovery in acute MI.
Publisher: England: BioMed Central Ltd
Language: English
Identifier: ISSN: 1532-429X
ISSN: 1097-6647
EISSN: 1532-429X
DOI: 10.1186/1532-429x-14-15
PMID: 22309452
Source: GFMER Free Medical Journals
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Cardiovascular magnetic resonance by non contrast T1-mapping allows assessment of severity of injury in acute myocardial infarction

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