scholarly journals Dark-Blood Delayed Enhancement Cardiac Magnetic Resonance of Myocardial Infarction

2018 ◽  
Vol 11 (12) ◽  
pp. 1758-1769 ◽  
Author(s):  
Han W. Kim ◽  
Wolfgang G. Rehwald ◽  
Elizabeth R. Jenista ◽  
David C. Wendell ◽  
Peter Filev ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Delayed Enhancement ◽  
Dark Blood

Delayed Enhancement Morphology on Cardiac Magnetic Resonance Imaging is Correlated with Signal-averaged Electrocardiogram and QT Dispersion in Myocardial Infarction

Angiology ◽  
2009 ◽  
Vol 60 (4) ◽  
pp. 412-418 ◽  
Author(s):  
Bonpei Takase ◽  
Masayoshi Nagata
Keyword(s):  
Magnetic Resonance Imaging ◽  
Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Cardiac Magnetic Resonance Imaging ◽  
Qt Dispersion ◽  
Scar Tissue ◽  
Delayed Enhancement ◽  
Resonance Imaging ◽  
Late Potential

Background In patients with myocardial infarction, ventricular tachycardia is related with nonconductive ventricular scar. Cardiac magnetic resonance imaging is an excellent modality to evaluate myocardial scars in myocardial infarction. Furthermore, late potential obtained from signal-averaged electrocardiogram and QT dispersion are both well-known parameters for predicting lethal arrhythmias. Methods and Results To investigate whether the pattern of necrotic scar tissue visualized by delayed enhancement on cardiac magnetic resonance imaging is associated with late potential and QT dispersion, we measured late potential and QT dispersion in 27 patients (68 ± 8 years old) with a prior myocardial infarction. Cardiac magnetic resonance imaging was also obtained using a 1.5-tesla cardiac magnetic resonance scanner, and delayed enhancement was analyzed in the short axis of the left ventricle. By conducting this, we tried to determine whether the pattern of necrotic scar tissue predicts lethal ventricular arrhythmias. Semiquantitative patchy scores were identified as the mean patchy score and the maximum patchy score in each patient. There were 9 patients with a positive late potential and 18 patients with a negative late potential. Patients with positive late potentials had significantly larger mean (1.7 ± 0.3) and maximum (2.2 ± 0.6) patchy scores than patients with negative late potentials (mean, 1.3 ± 0.2, P < .05; maximum, 1.7 ± 0.4, P < .05). QT dispersion was significantly correlated with the number of slices showing delayed enhancement, which reflects the size of necrotic scar tissue ( r = .59, P < .05). Conclusions These findings suggest that the pattern of necrotic scar tissue visualized by delayed enhancement with cardiac magnetic resonance imaging was correlated to the predictive indices of lethal ventricular arrhythmias.

scholarly journals Cardiac magnetic resonance derived global longitudinal strain outperfoms established functional parameters in prognostication after ST-elevation myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Holzknecht ◽  
M Reindl ◽  
C Tiller ◽  
I Lechner ◽  
T Hornung ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Prognostic Value ◽  
Longitudinal Strain ◽  
Independent Predictor ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Lv Function ◽  
St Elevation

Abstract Background Left ventricular ejection fraction (LVEF) is the parameter of choice for left ventricular (LV) function assessment and risk stratification of patients with ST-elevation myocardial infarction (STEMI); however, its prognostic value is limited. Other measures of LV function such as global longitudinal strain (GLS) and mitral annular plane systolic excursion (MAPSE) might provide additional prognostic information post-STEMI. However, comprehensive investigations comparing these parameters in terms of prediction of hard clinical events following STEMI are lacking so far. Purpose We aimed to investigate the comparative prognostic value of LVEF, MAPSE and GLS by cardiac magnetic resonance (CMR) imaging in the acute stage post-STEMI for the occurrence of major adverse cardiac events (MACE). Methods This observational study included 407 consecutive acute STEMI patients treated with primary percutaneous coronary intervention (PCI). Comprehensive CMR investigations were performed 3 [interquartile range (IQR): 2–4] days after PCI to determine LVEF, GLS and MAPSE as well as myocardial infarct characteristics. Primary endpoint was the occurrence of MACE defined as composite of death, re-infarction and congestive heart failure. Results During a follow-up of 21 [IQR: 12–50] months, 40 (10%) patients experienced MACE. LVEF (p=0.005), MAPSE (p=0.001) and GLS (p&lt;0.001) were significantly related to MACE. GLS showed the highest prognostic value with an area under the curve (AUC) of 0.71 (95% CI 0.63–0.79; p&lt;0.001) compared to MAPSE (AUC: 0.67, 95% CI 0.58–0.75; p=0.001) and LVEF (AUC: 0.64, 95% CI 0.54–0.73; p=0.005). After multivariable analysis, GLS emerged as sole independent predictor of MACE (HR: 1.22, 95% CI 1.11–1.35; p&lt;0.001). Of note, GLS remained associated with MACE (p&lt;0.001) even after adjustment for infarct size and microvascular obstruction. Conclusion CMR-derived GLS emerged as strong and independent predictor of MACE after acute STEMI with additive prognostic validity to LVEF and parameters of myocardial damage. Funding Acknowledgement Type of funding source: None

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