Visualisation of presence, location, and transmural extent of healed Q-wave and non-Q-wave myocardial infarction

Edwin Wu, Robert M. Judd, John D. Vargas, Francis J. Klocke, Robert O. Bonow, Raymond J. Kim

Research output: Contribution to journalArticle

Abstract

Background: A technical advance in contrast-enhanced magnetic resonance imaging (MRI) has significantly improved image quality. We investigated whether healed myocardial infarction can be visualised as hyperenhanced regions with this new technique, and whether assessment of the transmural extent of infarction yields new physiological data. Methods: 82 MRI examinations were carried out in three groups: patients with healed myocardial infarction; patients with non-ischaemic cardiomyopathy; and healthy volunteers. Patients with healed myocardial infarction were prospectively enrolled after enyzmatically proven necrosis and imaged 3 months (SD 1) or 14 months (7) later, The MRI procedure used a segmented inversion-recovery gradient-echo sequence after gadolinium administration. Findings were compared with those of coronary angiography, electrocardiography, cine MRI, and creatine kinase measurements. Findings: 29 (91%) of 32 patients with infarcts imaged at 3 months (13 non-Q-wave) and all of 19 imaged at 14 months (eight non-Q-wave) showed hyperenhancement. In patients in whom the infarct-related-artery was identified by angiography, 24 of 25 imaged at 3 months and all of 14 imaged at 14 months had hyperenhancement in the appropriate territory. None of the 20 patients with nonischaemic cardiomyopathy or the 11 healthy volunteers showed hyperenhancement. Irrespective of the presence or absence of Q waves, the majority of patients with hyperenhancement had only non-transmural involvement. Normal left-ventricular contraction was shown in seven patients examined at 3 months and three examined at 14 months, but in these cases hyperenhancement was limited to the subendocardium. Interpretation: The presence, location, and transmural extent of healed Q-wave and non-Q-wave myocardial infarction can be accurately determined by contrast-enhanced MRI.

Original languageEnglish (US)
Pages (from-to)21-28
Number of pages8
JournalLancet
Volume357
Issue number9249
DOIs
StatePublished - Jan 6 2001
Externally publishedYes

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Myocardial Infarction
Magnetic Resonance Imaging
Cardiomyopathies
Healthy Volunteers
Cine Magnetic Resonance Imaging
Gadolinium
Creatine Kinase
Coronary Angiography
Infarction
Angiography
Electrocardiography
Necrosis
Arteries

ASJC Scopus subject areas

  • Medicine(all)

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Visualisation of presence, location, and transmural extent of healed Q-wave and non-Q-wave myocardial infarction. / Wu, Edwin; Judd, Robert M.; Vargas, John D.; Klocke, Francis J.; Bonow, Robert O.; Kim, Raymond J.

In: Lancet, Vol. 357, No. 9249, 06.01.2001, p. 21-28.

Research output: Contribution to journalArticle

Wu, Edwin ; Judd, Robert M. ; Vargas, John D. ; Klocke, Francis J. ; Bonow, Robert O. ; Kim, Raymond J. / Visualisation of presence, location, and transmural extent of healed Q-wave and non-Q-wave myocardial infarction. In: Lancet. 2001 ; Vol. 357, No. 9249. pp. 21-28.
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