PMID- 31943526
OWN - NLM
STAT- MEDLINE
DCOM- 20210514
LR  - 20210514
IS  - 1522-2586 (Electronic)
IS  - 1053-1807 (Linking)
VI  - 52
IP  - 2
DP  - 2020 Aug
TI  - Myocardial Extracellular Volume Fraction Allows Differentiation of Reversible 
      Versus Irreversible Myocardial Damage and Prediction of Adverse Left Ventricular 
      Remodeling of ST-Elevation Myocardial Infarction.
PG  - 476-487
LID - 10.1002/jmri.27047 [doi]
AB  - BACKGROUND: The relationship between dynamic changes of myocardial injury in 
      ST-elevation myocardial infarction (STEMI) patients and long-term prognosis is 
      still unclear. PURPOSE: To evaluate the extracellular volume fraction (ECV) in 
      the differentiation of reversible from irreversible myocardial injury and the 
      prediction value of left ventricular adverse remodeling in patients with STEMI 
      after reperfusion. STUDY TYPE: Prospective. POPULATION: Twenty-four STEMI 
      patients after reperfusion were included FIELD STRENGTH/SEQUENCE: 3.0 T, T(1) 
      mapping, ECV, T(2) -STIR, and late gadolinium enhancement (LGE). ASSESSMENT: All 
      the patients underwent cardiac MRI at four timepoints (days 1, 3, and 7, and at 
      6 months). The regions of interest (ROIs) were selected at the infarcted 
      myocardium (with/without intramyocardial hemorrhage [IMH] and microvascular 
      obstruction [MVO]). STATISTICAL TESTS: One-way analysis of variance and the 
      Kruskal-Wallis test were used for the statistical analysis. RESULTS: Native T(1) 
      of MI (without MVO/IMH) gradually decreased after reperfusion (P < 0.05). The ECV 
      of MI increased during the first 3 days and then slowly declined. Native T(1) of 
      MI with MVO/IMH was the lowest (1184 msec; 1108.5-1266), while ECV (78%; 
      65.5-87%) was the highest, P < 0.001. Native T(1) and ECV of salvageable 
      myocardium were higher than those of the remote myocardium but lower than those 
      of the MI without MVO or IMH (P < 0.001). ROC analysis revealed an area under the 
      curve (AUC) of ECV (0.85, P < 0.001) for differentiating infarcted and 
      salvageable myocardium was higher than that of native T(1) mapping (AUC: 0.63, 
      P < 0.001) in the first week after STEMI (P < 0.0001). T(1) and ECV differed 
      significantly between patients with and without left ventricle adverse remodeling 
      (P < 0.05). DATA CONCLUSION: Dynamic temporal changes in reversibly and 
      irreversibly damaged myocardia were differentiated via native T(1) and ECV 
      mapping after primary percutaneous coronary intervention in STEMI patients. ECV 
      may better reflect microvascular injury severity and myocardial viability. MI 
      with higher native T(1) and ECV or with severe microvascular injury (MVO and IMH) 
      was correlated with adverse LV remodeling. LEVEL OF EVIDENCE: 2 Technical 
      Efficacy Stage: 2 J. Magn. Reson. Imaging 2020. J. Magn. Reson. Imaging 
      2020;52:476-487.
CI  - (c) 2020 International Society for Magnetic Resonance in Medicine.
FAU - Chen, Bing-Hua
AU  - Chen BH
AUID- ORCID: 0000-0002-2718-8416
AD  - Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong 
      University, Shanghai, China.
FAU - An, Dong-Aolei
AU  - An DA
AD  - Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong 
      University, Shanghai, China.
FAU - He, Jie
AU  - He J
AD  - Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong 
      University, Shanghai, China.
FAU - Xu, Jian-Rong
AU  - Xu JR
AD  - Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong 
      University, Shanghai, China.
FAU - Wu, Lian-Ming
AU  - Wu LM
AUID- ORCID: 0000-0001-7381-5436
AD  - Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong 
      University, Shanghai, China.
FAU - Pu, Jun
AU  - Pu J
AD  - Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong 
      University, Shanghai, China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200114
PL  - United States
TA  - J Magn Reson Imaging
JT  - Journal of magnetic resonance imaging : JMRI
JID - 9105850
RN  - 0 (Contrast Media)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
MH  - Contrast Media
MH  - Gadolinium
MH  - Humans
MH  - Magnetic Resonance Imaging, Cine
MH  - Myocardium
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - *ST Elevation Myocardial Infarction/diagnostic imaging
MH  - Ventricular Remodeling
OTO - NOTNLM
OT  - ST elevation myocardial infarction
OT  - T1 mapping
OT  - cardiac magnetic resonance imaging
OT  - extracellular volume fraction
OT  - reperfusion
EDAT- 2020/01/17 06:00
MHDA- 2021/05/15 06:00
CRDT- 2020/01/17 06:00
PHST- 2019/11/05 00:00 [received]
PHST- 2019/12/17 00:00 [revised]
PHST- 2019/12/19 00:00 [accepted]
PHST- 2020/01/17 06:00 [pubmed]
PHST- 2021/05/15 06:00 [medline]
PHST- 2020/01/17 06:00 [entrez]
AID - 10.1002/jmri.27047 [doi]
PST - ppublish
SO  - J Magn Reson Imaging. 2020 Aug;52(2):476-487. doi: 10.1002/jmri.27047. Epub 2020 
      Jan 14.