PMID- 28821947 OWN - NLM STAT- MEDLINE DCOM- 20180620 LR - 20200330 IS - 1432-1084 (Electronic) IS - 0938-7994 (Print) IS - 0938-7994 (Linking) VI - 28 IP - 2 DP - 2018 Feb TI - The influence of microvascular injury on native T1 and T2* relaxation values after acute myocardial infarction: implications for non-contrast-enhanced infarct assessment. PG - 824-832 LID - 10.1007/s00330-017-5010-x [doi] AB - OBJECTIVES: Native T1 mapping and late gadolinium enhancement (LGE) imaging offer detailed characterisation of the myocardium after acute myocardial infarction (AMI). We evaluated the effects of microvascular injury (MVI) and intramyocardial haemorrhage on local T1 and T2* values in patients with a reperfused AMI. METHODS: Forty-three patients after reperfused AMI underwent cardiovascular magnetic resonance imaging (CMR) at 4 [3-5] days, including native MOLLI T1 and T2* mapping, STIR, cine imaging and LGE. T1 and T2* values were determined in LGE-defined regions of interest: the MI core incorporating MVI when present, the core-adjacent MI border zone (without any areas of MVI), and remote myocardium. RESULTS: Average T1 in the MI core was higher than in the MI border zone and remote myocardium. However, in the 20 (47%) patients with MVI, MI core T1 was lower than in patients without MVI (MVI 1048+/-78ms, no MVI 1111+/-89ms, p=0.02). MI core T2* was significantly lower in patients with MVI than in those without (MVI 20 [18-23]ms, no MVI 31 [26-39]ms, p<0.001). CONCLUSION: The presence of MVI profoundly affects MOLLI-measured native T1 values. T2* mapping suggested that this may be the result of intramyocardial haemorrhage. These findings have important implications for the interpretation of native T1 values shortly after AMI. KEY POINTS: * Microvascular injury after acute myocardial infarction affects local T1 and T2* values. * Infarct zone T1 values are lower if microvascular injury is present. * T2* mapping suggests that low infarct T1 values are likely haemorrhage. * T1 and T2* values are complimentary for correctly assessing post-infarct myocardium. FAU - Robbers, Lourens F H J AU - Robbers LFHJ AD - Department of Cardiology, VU University Medical Centre, ZH 5F012, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. FAU - Nijveldt, Robin AU - Nijveldt R AD - Department of Cardiology, VU University Medical Centre, ZH 5F012, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. FAU - Beek, Aernout M AU - Beek AM AD - Department of Cardiology, VU University Medical Centre, ZH 5F012, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. FAU - Teunissen, Paul F A AU - Teunissen PFA AD - Department of Cardiology, VU University Medical Centre, ZH 5F012, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. FAU - Hollander, Maurits R AU - Hollander MR AD - Department of Cardiology, VU University Medical Centre, ZH 5F012, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. FAU - Biesbroek, P Stefan AU - Biesbroek PS AD - Department of Cardiology, VU University Medical Centre, ZH 5F012, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. FAU - Everaars, Henk AU - Everaars H AD - Department of Cardiology, VU University Medical Centre, ZH 5F012, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. FAU - van de Ven, Peter M AU - van de Ven PM AD - Department of Clinical Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands. FAU - Hofman, Mark B M AU - Hofman MBM AD - Department of Physics and Medical Technology, VU University Medical Centre, Amsterdam, The Netherlands. FAU - van Royen, Niels AU - van Royen N AD - Department of Cardiology, VU University Medical Centre, ZH 5F012, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. FAU - van Rossum, Albert C AU - van Rossum AC AD - Department of Cardiology, VU University Medical Centre, ZH 5F012, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. ac.vrossum@vumc.nl. LA - eng PT - Journal Article DEP - 20170818 PL - Germany TA - Eur Radiol JT - European radiology JID - 9114774 RN - 0 (Contrast Media) RN - AU0V1LM3JT (Gadolinium) SB - IM MH - Contrast Media MH - Coronary Vessels/*diagnostic imaging/pathology MH - Female MH - Gadolinium MH - Hemorrhage/*diagnostic imaging/pathology MH - Humans MH - *Magnetic Resonance Imaging MH - Male MH - Microcirculation MH - Middle Aged MH - Myocardial Infarction/*diagnostic imaging/pathology MH - Myocardium/pathology PMC - PMC5740192 OTO - NOTNLM OT - Acute myocardial infarction OT - Cardiovascular Magnetic Resonance imaging OT - Microvascular injury OT - T1 mapping OT - T2* mapping COIS- GUARANTOR: The scientific guarantor of this publication is Dr. Robin Nijveldt. CONFLICT OF INTEREST: The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. FUNDING: The authors state that this work has not received any funding. STATISTICS AND BIOMETRY: One of the authors has significant statistical expertise (Peter van de Ven). No complex statistical methods were necessary for this paper. ETHICAL APPROVAL: Institutional Review Board approval was obtained. INFORMED CONSENT: Written informed consent was obtained from all subjects (patients) in this study. STUDY SUBJECTS OR COHORTS OVERLAP: Some study subjects or cohorts have been previously reported in Teunissen PF, de Waard GA, Hollander MR, Robbers LF, Danad I, Biesbroek PS, et al. Doppler-derived intracoronary physiology indices predict the occurrence of microvascular injury and microvascular perfusion deficits after angiographically successful primary percutaneous coronary intervention. Circ Cardiovasc Interv 2015 Mar;8(3). METHODOLOGY: * prospective * observational * single-centre study EDAT- 2017/08/20 06:00 MHDA- 2018/06/21 06:00 PMCR- 2017/08/18 CRDT- 2017/08/20 06:00 PHST- 2016/06/20 00:00 [received] PHST- 2017/07/27 00:00 [accepted] PHST- 2017/05/08 00:00 [revised] PHST- 2017/08/20 06:00 [pubmed] PHST- 2018/06/21 06:00 [medline] PHST- 2017/08/20 06:00 [entrez] PHST- 2017/08/18 00:00 [pmc-release] AID - 10.1007/s00330-017-5010-x [pii] AID - 5010 [pii] AID - 10.1007/s00330-017-5010-x [doi] PST - ppublish SO - Eur Radiol. 2018 Feb;28(2):824-832. doi: 10.1007/s00330-017-5010-x. Epub 2017 Aug 18.