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

Keywords

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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  • 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