Accuracy of Area at Risk Quantification by Cardiac Magnetic Resonance According to the Myocardial Infarction Territory

2017 ◽  
Vol 70 (5) ◽  
pp. 323-330
Author(s):  
Leticia Fernández-Friera ◽  
José Manuel García-Ruiz ◽  
Ana García-Álvarez ◽  
Rodrigo Fernández-Jiménez ◽  
Javier Sánchez-González ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
At Risk ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Area At Risk ◽  
Risk Quantification

scholarly journals Quantifying the area-at-risk of myocardial infarction in-vivo using arterial spin labeling cardiac magnetic resonance

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Rachel K. Dongworth ◽  
Adrienne E. Campbell-Washburn ◽  
Hector A. Cabrera-Fuentes ◽  
Heerajnarain Bulluck ◽  
Thomas Roberts ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
At Risk ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Arterial Spin Labeling ◽  
Spin Labeling ◽  
Area At Risk

Cardiac magnetic resonance in the intensive and cardiac care unit

2015 ◽  
Author(s):  
Juerg Schwitter ◽  
Jens Bremerich
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Chest Pain ◽  
Magnetic Resonance ◽  
Wide Spectrum ◽  
Cardiac Care ◽  
User Friendliness ◽  
Area At Risk ◽  
Acute Cardiac Care

Current applications of cardiac magnetic resonance offer a wide spectrum of indications in the setting of acute cardiac care. In particular, cardiac magnetic resonance is helpful for the differential diagnosis of chest pain by the detection of ischaemia, myocardial stunning, myocarditis, and pericarditis. Also, Takotsubo cardiomyopathy and acute aortic diseases can be evaluated by cardiac magnetic resonance and are important differential diagnoses in patients with acute chest pain. In patients with restricted windows for echocardiography, according to guidelines, cardiac magnetic resonance is the method of choice to evaluate complications of an acute myocardial infarction. In an acute myocardial infarction, cardiac magnetic resonance allows for a unique characterization of myocardial damage by quantifying necrosis, microvascular obstruction, oedema (i.e. area at risk), and haemorrhage. These features will help us to understand better the pathophysiological events during infarction and will also allow us to assess new treatment strategies in acute myocardial infarction. To which extent the information on tissue damage will guide patient management is not yet clear, and further research, e.g. in the setting of the European Cardiovascular MR registry, is ongoing to address this issue. Recent studies also demonstrated the possiblity to reduce costs in the management of acute coronary syndromes when cardiac magnetic resonance is integrated into the routine work-up. In the near future, applications of cardiac magnetic resonance will continue to expand in the acute cardiac care units, as manufacturers are now strongly focusing on this aspect of user-friendliness. Finally, in the next decade or so, magnetic resonance imaging of other nuclei, such as fluorine and carbon, might become a reality in clinics, which would allow for metabolic and targeted molecular imaging with excellent sensitivity and specificity.

Cardiac magnetic resonance in the intensive and cardiac care unit

2018 ◽  
Author(s):  
Juerg Schwitter ◽  
Jens Bremerich
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Chest Pain ◽  
Magnetic Resonance ◽  
Wide Spectrum ◽  
Cardiac Care ◽  
User Friendliness ◽  
Area At Risk ◽  
Acute Cardiac Care

Current applications of cardiac magnetic resonance offer a wide spectrum of indications in the setting of acute cardiac care. In particular, cardiac magnetic resonance is helpful for the differential diagnosis of chest pain by the detection of ischaemia, myocardial stunning, myocarditis, and pericarditis. Also, Takotsubo cardiomyopathy and acute aortic diseases can be evaluated by cardiac magnetic resonance and are important differential diagnoses in patients with acute chest pain. In patients with restricted windows for echocardiography, according to guidelines, cardiac magnetic resonance is the method of choice to evaluate complications of an acute myocardial infarction. In an acute myocardial infarction, cardiac magnetic resonance allows for a unique characterization of myocardial damage by quantifying necrosis, microvascular obstruction, oedema (i.e. area at risk), and haemorrhage. These features will help us to understand better the pathophysiological events during infarction and will also allow us to assess new treatment strategies in acute myocardial infarction. To which extent the information on tissue damage will guide patient management is not yet clear, and further research, e.g. in the setting of the European Cardiovascular MR registry, is ongoing to address this issue. Recent studies also demonstrated the possiblity to reduce costs in the management of acute coronary syndromes when cardiac magnetic resonance is integrated into the routine work-up. In the near future, applications of cardiac magnetic resonance will continue to expand in the acute cardiac care units, as manufacturers are now strongly focusing on this aspect of user-friendliness. Finally, in the next decade or so, magnetic resonance imaging of other nuclei, such as fluorine and carbon, might become a reality in clinics, which would allow for metabolic and targeted molecular imaging with excellent sensitivity and specificity.

Abstract 14005: Myocardium at Risk in Revascularized Non-ST-Elevation Myocardial Infarction Assessed by Cardiac Magnetic Resonance Imaging and Validated by the Invasive Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease Score

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Dominik Buckert ◽  
Nils Dyckmanns ◽  
Volker Rasche ◽  
Wolfgang Rottbauer ◽  
Peter Bernhardt
Keyword(s):  
Magnetic Resonance Imaging ◽  
Myocardial Infarction ◽  
At Risk ◽  
Coronary Heart Disease ◽  
Cardiac Magnetic Resonance ◽  
Disease Score ◽  
Resonance Imaging ◽  
Area At Risk ◽  
X Ray ◽  
St Elevation

Background: In the setting of acute myocardial ischemia, the hypoperfused portion of the myocardium is in danger of becoming irreversibly injured. This portion of myocardium is often referred to as area at risk (AAR) and is correlated to adverse events and outcome. Hypothesis: Aim of the trial at hand was to assess the AAR in patients with acute non-ST-elevation myocardial infarction (NSTEMI) by cardiac magnetic resonance imaging (CMR). Results were validated by the well-established Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease Score (APPROACH-score) that was assessed by invasive coronary x-ray angiography. Methods: Sixty-four patients presenting with acute NSTEMI who underwent coronary x-ray angiography including subsequent percutaneous coronary intervention within 72 hours of symptom onset were enrolled. Two blinded readers performed offline angiographic AAR assessment using the modified APPROACH-score. For measurement of AAR by CMR, a 1.5 T whole-body scanner with a 32-channel phased-array surface coil was used. Besides functional and volumetric analyses, a 3D T2-weighted black-blood fat-saturated spin-echo sequence was used for visualization of myocardial edema. Area at risk was calculated as edema volume in relation to left ventricular mass. Using this technique, AAR was quantified semi-automatically by two blinded readers in consensus. Results: Mean age of study cohort was 62.9 years. Forty-four subjects were male (73.3%), mean symptom-to-balloon time was 1212 ± 976 min. The resulting mean AAR determined by the modified APPROACH-score was 28.6 ± 10.0%. The mean CMR derived AAR was 27.9 ± 13.7%. CMR assessment tended to slightly underestimate the AAR in comparison to angiographic scoring (difference -0.21 ± 8.1 %, p=NS). A good correlation between the AAR assessed by CMR and by angiography (r=0.84, p<0.0001) was observed. Conclusion: T2-weigthed CMR is able to quantify the AAR with very good correlation to the angiographic APPROACH-score in NSTEMI patients. Therefore, CMR might serve as an excellent surrogate in clinical reperfusion trials.

scholarly journals The Salvaged Area at Risk in Reperfused Acute Myocardial Infarction as Visualized by Cardiovascular Magnetic Resonance

2008 ◽  
Vol 51 (16) ◽  
pp. 1581-1587 ◽  
Author(s):  
Matthias G. Friedrich ◽  
Hassan Abdel-Aty ◽  
Andrew Taylor ◽  
Jeanette Schulz-Menger ◽  
Daniel Messroghli ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
At Risk ◽  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Area At Risk ◽  
Reperfused Acute Myocardial Infarction
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