TY - JOUR
T1 - Cardiovascular magnetic resonance characterization of peri-infarct zone remodeling following myocardial infarction
AU - Schuleri, Karl H.
AU - Centola, Marco
AU - Evers, Kristine S.
AU - Zviman, Adam
AU - Evers, Robert
AU - Lima, João A.C.
AU - Lardo, Albert C.
N1 - Funding Information:
This work was supported by NIH grant U54 HL081028, and The Donald W. Reynolds foundation. The authors thank Norman J. Barker, M.S., R.B.P. for his expertise and helpful suggestions presenting images and data visually.
PY - 2012
Y1 - 2012
N2 - Background: Clinical studies implementing late gadolinium-enhanced (LGE) cardiovascular magnetic resonance (CMR) studies suggest that the peri-infarct zone (PIZ) contains a mixture of viable and non-viable myocytes, and is associated with greater susceptibility to ventricular tachycardia induction and adverse cardiac outcomes. However, CMR data assessing the temporal formation and functional remodeling characteristics of this complex region are limited. We intended to characterize early temporal changes in scar morphology and regional function in the PIZ. Methods and results. CMR studies were performed at six time points up to 90 days after induction of myocardial infarction (MI) in eight minipigs with reperfused, anterior-septal infarcts. Custom signal density threshold algorithms, based on the remote myocardium, were applied to define the infarct core and PIZ region for each time point. After the initial post-MI edema subsided, the PIZ decreased by 54% from day 10 to day 90 (p = 0.04). The size of infarct scar expanded by 14% and thinned by 56% from day 3 to 12 weeks (p = 0.004 and p < 0.001, respectively). LVEDV increased from 34.7. 2.2 ml to 47.8 3.0 ml (day3 and week12, respectively; p < 0.001). At 30 days post-MI, regional circumferential strain was increased between the infarct scar and the PIZ (-2.1 0.6 and -6.8 0.9, respectively;* p < 0.05). Conclusions: The PIZ is dynamic and decreases in mass following reperfused MI. Tensile forces in the PIZ undergo changes following MI. Remodeling characteristics of the PIZ may provide mechanistic insights into the development of life-threatening arrhythmias and sudden cardiac death post-MI.
AB - Background: Clinical studies implementing late gadolinium-enhanced (LGE) cardiovascular magnetic resonance (CMR) studies suggest that the peri-infarct zone (PIZ) contains a mixture of viable and non-viable myocytes, and is associated with greater susceptibility to ventricular tachycardia induction and adverse cardiac outcomes. However, CMR data assessing the temporal formation and functional remodeling characteristics of this complex region are limited. We intended to characterize early temporal changes in scar morphology and regional function in the PIZ. Methods and results. CMR studies were performed at six time points up to 90 days after induction of myocardial infarction (MI) in eight minipigs with reperfused, anterior-septal infarcts. Custom signal density threshold algorithms, based on the remote myocardium, were applied to define the infarct core and PIZ region for each time point. After the initial post-MI edema subsided, the PIZ decreased by 54% from day 10 to day 90 (p = 0.04). The size of infarct scar expanded by 14% and thinned by 56% from day 3 to 12 weeks (p = 0.004 and p < 0.001, respectively). LVEDV increased from 34.7. 2.2 ml to 47.8 3.0 ml (day3 and week12, respectively; p < 0.001). At 30 days post-MI, regional circumferential strain was increased between the infarct scar and the PIZ (-2.1 0.6 and -6.8 0.9, respectively;* p < 0.05). Conclusions: The PIZ is dynamic and decreases in mass following reperfused MI. Tensile forces in the PIZ undergo changes following MI. Remodeling characteristics of the PIZ may provide mechanistic insights into the development of life-threatening arrhythmias and sudden cardiac death post-MI.
KW - Cardiovascular magnetic resonance imaging
KW - Late gadolinium enhancement
KW - Myocardial infarction
KW - Myocardial strain
KW - Peri-infarct zone
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U2 - 10.1186/1532-429X-14-24
DO - 10.1186/1532-429X-14-24
M3 - Article
C2 - 22510220
AN - SCOPUS:84864403783
SN - 1097-6647
VL - 14
JO - Journal of Cardiovascular Magnetic Resonance
JF - Journal of Cardiovascular Magnetic Resonance
IS - 1
M1 - 24
ER -