Early assessment of myocardial salvage by contrast-enhanced magnetic resonance imaging

Hanns B. Hillenbrand, Raymond J. Kim, Michele A. Parker, David S. Fieno, Robert M. Judd

Research output: Contribution to journalArticle

Abstract

Background - Myocardial salvage after acute myocardial infarction is defined clinically by early restoration of flow and long-term improvement in contractile function. We hypothesized that contrast-enhanced magnetic resonance imaging (MRI), performed early after myocardial infarction, indexes myocardial salvage. We studied the relationship between the transmural extent of hyperenhancement by contrast-enhanced MRI, restoration of flow, and recovery of function. Methods and Results - The left anterior descending coronary artery was occluded in dogs (n=15) for either 45 minutes, I 90 minutes, or permanently. Cine and contrast-enhanced MRI were performed 3 days after the procedure; cine MRI was also done 10 and 28 days after the procedure. The transmural extent of hyperenhancement and wall thickening were determined using a 60-segment model. The mean transmural extent of hyperenhancement for the 45-minute occlusion group was 22% of the 90-minute group and 18% of the permanent occlusion group (P<0.05 for both). The transmural extent of hyperenhancement on day 3 was related to future improvement in both wall thickening score and absolute wall thickening at 10 and 28 days (P<0.0001 for each). For example, of the 415 segments on day 3 that were dysfunctional and had <25% transmural hyperenhancement, 362 (87%) improved by day 28. Conversely, no segments (0 of 9) with 100% hyperenhancement improved. The transmural extent of hyperenhancement on day 3 was a better predictor of improvement in contractile function than occlusion time (P<0.0001). Conclusions - A reduction in the transmural extent of hyperenhancement by contrast-enhanced MRI early after myocardial infarction is associated with an early restoration of flow and future improvement in contractile function.

Original languageEnglish (US)
Pages (from-to)1678-1683
Number of pages6
JournalCirculation
Volume102
Issue number14
DOIs
StatePublished - Oct 3 2000
Externally publishedYes

Fingerprint

Magnetic Resonance Imaging
Myocardial Infarction
Cine Magnetic Resonance Imaging
Recovery of Function
Coronary Vessels
Dogs

Keywords

  • Contrast media
  • Magnetic resonance imaging
  • Myocardial infarction
  • Salvage therapy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Hillenbrand, H. B., Kim, R. J., Parker, M. A., Fieno, D. S., & Judd, R. M. (2000). Early assessment of myocardial salvage by contrast-enhanced magnetic resonance imaging. Circulation, 102(14), 1678-1683. https://doi.org/10.1161/01.CIR.102.14.1678

Early assessment of myocardial salvage by contrast-enhanced magnetic resonance imaging. / Hillenbrand, Hanns B.; Kim, Raymond J.; Parker, Michele A.; Fieno, David S.; Judd, Robert M.

In: Circulation, Vol. 102, No. 14, 03.10.2000, p. 1678-1683.

Research output: Contribution to journalArticle

Hillenbrand, HB, Kim, RJ, Parker, MA, Fieno, DS & Judd, RM 2000, 'Early assessment of myocardial salvage by contrast-enhanced magnetic resonance imaging', Circulation, vol. 102, no. 14, pp. 1678-1683. https://doi.org/10.1161/01.CIR.102.14.1678
Hillenbrand, Hanns B. ; Kim, Raymond J. ; Parker, Michele A. ; Fieno, David S. ; Judd, Robert M. / Early assessment of myocardial salvage by contrast-enhanced magnetic resonance imaging. In: Circulation. 2000 ; Vol. 102, No. 14. pp. 1678-1683.
@article{19122bf48527491e9cfaf6a1151f0289,
title = "Early assessment of myocardial salvage by contrast-enhanced magnetic resonance imaging",
abstract = "Background - Myocardial salvage after acute myocardial infarction is defined clinically by early restoration of flow and long-term improvement in contractile function. We hypothesized that contrast-enhanced magnetic resonance imaging (MRI), performed early after myocardial infarction, indexes myocardial salvage. We studied the relationship between the transmural extent of hyperenhancement by contrast-enhanced MRI, restoration of flow, and recovery of function. Methods and Results - The left anterior descending coronary artery was occluded in dogs (n=15) for either 45 minutes, I 90 minutes, or permanently. Cine and contrast-enhanced MRI were performed 3 days after the procedure; cine MRI was also done 10 and 28 days after the procedure. The transmural extent of hyperenhancement and wall thickening were determined using a 60-segment model. The mean transmural extent of hyperenhancement for the 45-minute occlusion group was 22{\%} of the 90-minute group and 18{\%} of the permanent occlusion group (P<0.05 for both). The transmural extent of hyperenhancement on day 3 was related to future improvement in both wall thickening score and absolute wall thickening at 10 and 28 days (P<0.0001 for each). For example, of the 415 segments on day 3 that were dysfunctional and had <25{\%} transmural hyperenhancement, 362 (87{\%}) improved by day 28. Conversely, no segments (0 of 9) with 100{\%} hyperenhancement improved. The transmural extent of hyperenhancement on day 3 was a better predictor of improvement in contractile function than occlusion time (P<0.0001). Conclusions - A reduction in the transmural extent of hyperenhancement by contrast-enhanced MRI early after myocardial infarction is associated with an early restoration of flow and future improvement in contractile function.",
keywords = "Contrast media, Magnetic resonance imaging, Myocardial infarction, Salvage therapy",
author = "Hillenbrand, {Hanns B.} and Kim, {Raymond J.} and Parker, {Michele A.} and Fieno, {David S.} and Judd, {Robert M.}",
year = "2000",
month = "10",
day = "3",
doi = "10.1161/01.CIR.102.14.1678",
language = "English (US)",
volume = "102",
pages = "1678--1683",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "14",

}

TY - JOUR

T1 - Early assessment of myocardial salvage by contrast-enhanced magnetic resonance imaging

AU - Hillenbrand, Hanns B.

AU - Kim, Raymond J.

AU - Parker, Michele A.

AU - Fieno, David S.

AU - Judd, Robert M.

PY - 2000/10/3

Y1 - 2000/10/3

N2 - Background - Myocardial salvage after acute myocardial infarction is defined clinically by early restoration of flow and long-term improvement in contractile function. We hypothesized that contrast-enhanced magnetic resonance imaging (MRI), performed early after myocardial infarction, indexes myocardial salvage. We studied the relationship between the transmural extent of hyperenhancement by contrast-enhanced MRI, restoration of flow, and recovery of function. Methods and Results - The left anterior descending coronary artery was occluded in dogs (n=15) for either 45 minutes, I 90 minutes, or permanently. Cine and contrast-enhanced MRI were performed 3 days after the procedure; cine MRI was also done 10 and 28 days after the procedure. The transmural extent of hyperenhancement and wall thickening were determined using a 60-segment model. The mean transmural extent of hyperenhancement for the 45-minute occlusion group was 22% of the 90-minute group and 18% of the permanent occlusion group (P<0.05 for both). The transmural extent of hyperenhancement on day 3 was related to future improvement in both wall thickening score and absolute wall thickening at 10 and 28 days (P<0.0001 for each). For example, of the 415 segments on day 3 that were dysfunctional and had <25% transmural hyperenhancement, 362 (87%) improved by day 28. Conversely, no segments (0 of 9) with 100% hyperenhancement improved. The transmural extent of hyperenhancement on day 3 was a better predictor of improvement in contractile function than occlusion time (P<0.0001). Conclusions - A reduction in the transmural extent of hyperenhancement by contrast-enhanced MRI early after myocardial infarction is associated with an early restoration of flow and future improvement in contractile function.

AB - Background - Myocardial salvage after acute myocardial infarction is defined clinically by early restoration of flow and long-term improvement in contractile function. We hypothesized that contrast-enhanced magnetic resonance imaging (MRI), performed early after myocardial infarction, indexes myocardial salvage. We studied the relationship between the transmural extent of hyperenhancement by contrast-enhanced MRI, restoration of flow, and recovery of function. Methods and Results - The left anterior descending coronary artery was occluded in dogs (n=15) for either 45 minutes, I 90 minutes, or permanently. Cine and contrast-enhanced MRI were performed 3 days after the procedure; cine MRI was also done 10 and 28 days after the procedure. The transmural extent of hyperenhancement and wall thickening were determined using a 60-segment model. The mean transmural extent of hyperenhancement for the 45-minute occlusion group was 22% of the 90-minute group and 18% of the permanent occlusion group (P<0.05 for both). The transmural extent of hyperenhancement on day 3 was related to future improvement in both wall thickening score and absolute wall thickening at 10 and 28 days (P<0.0001 for each). For example, of the 415 segments on day 3 that were dysfunctional and had <25% transmural hyperenhancement, 362 (87%) improved by day 28. Conversely, no segments (0 of 9) with 100% hyperenhancement improved. The transmural extent of hyperenhancement on day 3 was a better predictor of improvement in contractile function than occlusion time (P<0.0001). Conclusions - A reduction in the transmural extent of hyperenhancement by contrast-enhanced MRI early after myocardial infarction is associated with an early restoration of flow and future improvement in contractile function.

KW - Contrast media

KW - Magnetic resonance imaging

KW - Myocardial infarction

KW - Salvage therapy

UR - http://www.scopus.com/inward/record.url?scp=0034601759&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034601759&partnerID=8YFLogxK

U2 - 10.1161/01.CIR.102.14.1678

DO - 10.1161/01.CIR.102.14.1678

M3 - Article

C2 - 11015347

AN - SCOPUS:0034601759

VL - 102

SP - 1678

EP - 1683

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 14

ER -