TY - JOUR
T1 - Assessment of distribution and evolution of Mechanical dyssynchrony in a porcine model of myocardial infarction by cardiovascular magnetic resonance
AU - Abd-Elmoniem, Khaled Z.
AU - Tomas, Miguel Santaularia
AU - Sasano, Tetsuo
AU - Soleimanifard, Sahar
AU - Vonken, Evert Jan P.
AU - Youssef, Amr
AU - Agarwal, Harsh
AU - Dimaano, Veronica L.
AU - Calkins, Hugh
AU - Stuber, Matthias
AU - Prince, Jerry L.
AU - Abraham, Theodore P.
AU - Abraham, M. Roselle
N1 - Funding Information:
We thank John Terrovitis, MD for help with designing the imaging protocol, Michael Schär, PhD for kindly providing the technical expertise for critical portions of the CMR imaging, Kevin Mills, BS and Mohammed Zauher, BS for help with animal studies. This work was supported by the Donald W. Reynolds Foundation. We would also like to thank Ronnie Abbo and Biosense Webster for providing us the catheters and the CARTO XP system used in this study. We are grateful to Dr. Henry Halperin for use of his research EP laboratory.
PY - 2012
Y1 - 2012
N2 - Background: We sought to investigate the relationship between infarct and dyssynchrony post- myocardial infarct (MI), in a porcine model. Mechanical dyssynchrony post-MI is associated with left ventricular (LV) remodeling and increased mortality. Methods. Cine, gadolinium-contrast, and tagged cardiovascular magnetic resonance (CMR) were performed pre-MI, 9 2 days (early post-MI), and 33 10 days (late post-MI) post-MI in 6 pigs to characterize cardiac morphology, location and extent of MI, and regional mechanics. LV mechanics were assessed by circumferential strain (eC). Electro-anatomic mapping (EAM) was performed within 24 hrs of CMR and prior to sacrifice. Results: Mean infarct size was 21 4% of LV volume with evidence of post-MI remodeling. Global eC significantly decreased post MI (-27 1.6% vs. -18 2.5% (early) and -17 2.7% (late), p < 0.0001) with no significant change in peri-MI and MI segments between early and late time-points. Time to peak strain (TTP) was significantly longer in MI, compared to normal and peri-MI segments, both early (440 40 ms vs. 329 40 ms and 332 36 ms, respectively; p = 0.0002) and late post-MI (442 63 ms vs. 321 40 ms and 355 61 ms, respectively; p = 0.012). The standard deviation of TTP in 16 segments (SD16) significantly increased post-MI: 28 7 ms to 50 10 ms (early, p = 0.012) to 54 19 ms (late, p = 0.004), with no change between early and late post-MI time-points (p = 0.56). TTP was not related to reduction of segmental contractility. EAM revealed late electrical activation and greatly diminished conduction velocity in the infarct (5.7 2.4 cm/s), when compared to peri-infarct (18.7 10.3 cm/s) and remote myocardium (39 20.5 cm/s). Conclusions: Mechanical dyssynchrony occurs early after MI and is the result of delayed electrical and mechanical activation in the infarct.
AB - Background: We sought to investigate the relationship between infarct and dyssynchrony post- myocardial infarct (MI), in a porcine model. Mechanical dyssynchrony post-MI is associated with left ventricular (LV) remodeling and increased mortality. Methods. Cine, gadolinium-contrast, and tagged cardiovascular magnetic resonance (CMR) were performed pre-MI, 9 2 days (early post-MI), and 33 10 days (late post-MI) post-MI in 6 pigs to characterize cardiac morphology, location and extent of MI, and regional mechanics. LV mechanics were assessed by circumferential strain (eC). Electro-anatomic mapping (EAM) was performed within 24 hrs of CMR and prior to sacrifice. Results: Mean infarct size was 21 4% of LV volume with evidence of post-MI remodeling. Global eC significantly decreased post MI (-27 1.6% vs. -18 2.5% (early) and -17 2.7% (late), p < 0.0001) with no significant change in peri-MI and MI segments between early and late time-points. Time to peak strain (TTP) was significantly longer in MI, compared to normal and peri-MI segments, both early (440 40 ms vs. 329 40 ms and 332 36 ms, respectively; p = 0.0002) and late post-MI (442 63 ms vs. 321 40 ms and 355 61 ms, respectively; p = 0.012). The standard deviation of TTP in 16 segments (SD16) significantly increased post-MI: 28 7 ms to 50 10 ms (early, p = 0.012) to 54 19 ms (late, p = 0.004), with no change between early and late post-MI time-points (p = 0.56). TTP was not related to reduction of segmental contractility. EAM revealed late electrical activation and greatly diminished conduction velocity in the infarct (5.7 2.4 cm/s), when compared to peri-infarct (18.7 10.3 cm/s) and remote myocardium (39 20.5 cm/s). Conclusions: Mechanical dyssynchrony occurs early after MI and is the result of delayed electrical and mechanical activation in the infarct.
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U2 - 10.1186/1532-429X-14-1
DO - 10.1186/1532-429X-14-1
M3 - Article
C2 - 22226320
AN - SCOPUS:84860596584
SN - 1097-6647
VL - 14
JO - Journal of Cardiovascular Magnetic Resonance
JF - Journal of Cardiovascular Magnetic Resonance
IS - 1
M1 - 1
ER -