CMR imaging for the evaluation of myocardial stunning after acute myocardial infarction: a meta-analysis of prospective trials

Abstract

DE-CMR has a higher sensitivity, whereas LDD-CMR has a higher specificity for the detection of viable stunned myocardium following myocardial infarction. Whether the combination of DE and LDD may improve the prediction of myocardial recovery remains to be determined.

Role of cardiovascular magnetic resonance in the management of patients with stable coronary artery disease

“…In acute MI, cellular necrosis is associated with cell membrane rupture and increase in gadolinium distribution, and in chronic MI, the extracellular space is increased due to collagen deposition . In chronic MI, the prediction of functional recovery based on the transmural extent of LGE has become the clinical reference standard 33. Given that quantification of infarct size by LGE imaging is also highly reproducible, it is increasingly used as a surrogate endpoint in clinical trials comparing novel therapies for infarct size reduction following ST-elevation MI.…”

Advances in cardiovascular magnetic resonance in ischaemic heart disease and non-ischaemic cardiomyopathies

“…w39 A recent meta-analysis of 11 studies enrolling 379 patients acutely after ST elevation MI (STEMI) found LGE imaging to have a weighted sensitivity and specificity of 87% and 68%, respectively, for the prediction of wall motion improvement 18. LGE imaging also has grade A appropriateness for use in cases of ‘MI with normal coronary arteries’, as it can sensitively detect alternative aetiologies such as Takotsubo cardiomyopathy or myocarditis, and can rule-in atherosclerotic (non-occlusive) plaque events by characteristic hyperenhancement beginning in the subendocardium typical of infarction.…”

“…In particular, the prediction of functional recovery based on the transmural extent of LGE has become the clinical reference standard 18. Given that quantification of infarct size by LGE imaging is also highly reproducible, it has increasingly been used as a surrogate endpoint for clinical trials comparing infarction therapies.…”

The year 2012 in the European Heart Journal - Cardiovascular Imaging: Part I

“…26 In a second study of 199 patients with acute ST elevation (STE) MI, CMR measures on LA function were independently associated with the outcome. 27 Other studies highlighted the value of combined low-dose dobutamine and LGE CMR in the prediction of remodelling, 28 which was also the topic of a meta-analysis, 29 and the infarct border zone by LGE in the prediction of hard clinical endpoints. 30 Other CMR outcome measures were reviewed in the European Heart JournalCardiovascular Imaging by Mavrogeni et al…”