PMID- 23179525
OWN - NLM
STAT- MEDLINE
DCOM- 20130930
LR  - 20211021
IS  - 1432-1084 (Electronic)
IS  - 0938-7994 (Linking)
VI  - 23
IP  - 5
DP  - 2013 May
TI  - Salvage assessment with cardiac MRI following acute myocardial infarction 
      underestimates potential for recovery of systolic strain.
PG  - 1210-7
LID - 10.1007/s00330-012-2715-8 [doi]
AB  - OBJECTIVES: Our aim was to evaluate the relationship between the degree of 
      salvage following acute ST elevation myocardial infarction (STEMI) and subsequent 
      reversible contractile dysfunction using cardiac magnetic resonance (CMR) 
      imaging. METHODS: Thirty-four patients underwent CMR examination 1-7 days after 
      primary percutaneous coronary intervention (PPCI) for acute STEMI with follow-up 
      at 1 year. The ischaemic area-at-risk (AAR) was assessed with T2-weighted imaging 
      and myocardial necrosis with late gadolinium enhancement. Myocardial strain was 
      quantified with complementary spatial modulation of magnetisation (CSPAMM) 
      tagging. RESULTS: Ischaemic segments with poor (<25 %) or intermediate (26-50 %) 
      salvage index were associated with worse Eulerian circumferential (Ecc) strain 
      immediately post-PPCI (-9.1 % +/- 0.6, P = 0.033 and -11.8 % +/- 1.3, P = 0.003, 
      respectively) than those with a high (51-100 %) salvage index (-14.4 % +/- 1.3). 
      Mean strain in ischaemic myocardium improved between baseline and follow-up 
      (-10.1 % +/- 0.5 vs. -16.2 % +/- 0.5 %, P < 0.0001). Segments with poor salvage also 
      showed an improvement in strain by 1 year (-9.1 % +/- 0.6 vs. -15.3 % +/- 0.6, P = 
      0.033) although they remained the most functionally impaired. CONCLUSIONS: 
      Partial recovery of peak systolic strain following PPCI is observed even when 
      apparent salvage is less than 25 %. Late gadolinium enhancement (LGE) may not 
      equate to irreversibly injured myocardium and salvage assessment performed within 
      the first week of revascularisation may underestimate the potential for 
      functional recovery. KEY POINTS: * MRI can measure how much myocardium is damaged 
      after a heart attack. * Heart muscle that appears initially non-viable may 
      sometimes partially recover. * Enhancement around the edges of infarcts may 
      resolve over time. * Evaluating new cardio-protective treatments with MRI 
      requires appreciation of its limitations.
FAU - O'Regan, Declan P
AU  - O'Regan DP
AD  - Robert Steiner MRI Unit, MRC Clinical Sciences Centre, Imperial College London, 
      Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK. 
      declan.oregan@imperial.ac.uk
FAU - Ariff, Ben
AU  - Ariff B
FAU - Baksi, A John
AU  - Baksi AJ
FAU - Gordon, Fabiana
AU  - Gordon F
FAU - Durighel, Giuliana
AU  - Durighel G
FAU - Cook, Stuart A
AU  - Cook SA
LA  - eng
GR  - MC_U120085815/MRC_/Medical Research Council/United Kingdom
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20121124
PL  - Germany
TA  - Eur Radiol
JT  - European radiology
JID - 9114774
SB  - IM
MH  - Adult
MH  - Algorithms
MH  - Elastic Modulus
MH  - Elasticity Imaging Techniques/*methods
MH  - Female
MH  - Humans
MH  - Image Interpretation, Computer-Assisted/*methods
MH  - Magnetic Resonance Imaging, Cine/*methods
MH  - Male
MH  - Myocardial Infarction/*diagnosis/physiopathology/*surgery
MH  - *Recovery of Function
MH  - Reproducibility of Results
MH  - Salvage Therapy/*methods
MH  - Sensitivity and Specificity
MH  - Treatment Outcome
EDAT- 2012/11/28 06:00
MHDA- 2013/10/01 06:00
CRDT- 2012/11/27 06:00
PHST- 2012/08/22 00:00 [received]
PHST- 2012/10/10 00:00 [accepted]
PHST- 2012/10/05 00:00 [revised]
PHST- 2012/11/27 06:00 [entrez]
PHST- 2012/11/28 06:00 [pubmed]
PHST- 2013/10/01 06:00 [medline]
AID - 10.1007/s00330-012-2715-8 [doi]
PST - ppublish
SO  - Eur Radiol. 2013 May;23(5):1210-7. doi: 10.1007/s00330-012-2715-8. Epub 2012 Nov 
      24.