Comparison of wall thickening and ejection fraction by cardiovascular magnetic resonance and echocardiography in acute myocardial infarction

Abstract

Objectives: The purpose of this study was to compare cardiovascular magnetic resonance (CMR) and echocardiography (echo) in patients treated with primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) with emphasis on the analysis of left ventricular function and left ventricular wall motion characteristics. Methods:We performed CMR and echo in 52 patients with first AMI shortly after primary angioplasty and four months thereafter. CMR included cine-MR and T1-weighted first-pass and lategadolinium enhancement (LGE) sequences. Global ejection fraction (EF CMR , %) and regional left ventricular function (systolic wall thickening %, [SWT]) were determined from cine-MR images. In echo the global left ventricular function (EF echo , %) and regional wall motion abnormalities were determined. A segment in echo was scored as "infarcted" if it was visually > 50% hypokinetic.Results: EF echo revealed a poor significant agreement with EF CMR at baseline (r: 0.326; p < 0.01) but higher correlation at follow-up (r: 0.479; p < 0.001). The number of infarcted segments in echocardiography correlated best with the number of segments which showed systolic wall thickening < 30% (r: 0.498; p < 0.001) at baseline and (r: 0.474; p < 0.001) at follow-up. Improvement of EF was detected in both CMR and echocardiography increasing from 44.2 ± 11.6% to 49.2 ± 11% (p < 0.001) by CMR and from 51.2 ± 8.1% to 54.5 ± 8.3% (p < 0.001) by echocardiography. Conclusion:Wall motion and EF by CMR and echocardiography correlate poorly in the acute stage of myocardial infarction. Correlation improves after four months. Systolic wall thickening by CMR < 30% indicates an infarcted segment with influence on the left ventricular function.

Coronary Wave Energy

“…Percentage of recovery in ventricular function was assessed according to whether ≥30% recovery in regional wall thickening was observed after PCI. 28,29 Using this characterization, receiver-operator characteristic analysis was performed to determine a cutoff value with maximal diagnostic accuracy for diastolic microcirculatory wave intensity (BEW) and hMR, in predicting regional recovery in function, with the difference between the 2 indices assessed using the Delong receiver-operator characteristic comparison analysis. 30 Data are presented as median with 25% to 75% interquartile ranges, unless otherwise specified.…”

Use of Cardiac Magnetic Resonance and Echocardiography in Population-Based Studies

“…These variations seem drastic in the current era and may reflect the use of a former-generation echo machine. As one might expect, the differences were mostly marked between 2D echocardiography and CMR in the postinfarct population, 11 where the role of CMR as a fundamentally 3-dimensional (3D) approach led to estimation of a lower EF (44±12% versus 51±8%), although this may have been accentuated by somewhat earlier performance of CMR (2.8±1.6 versus 3.4±1.7 days after infarction). In a recent meta-analysis, 12 end-diastolic and end-systolic volumes were underestimated by 2D echocardiography by 48.2±55.9 and 27.7±45.7 mL, respectively, although the bias for EF was small (0.1±13.9%).…”

Cardiac index after acute ST-segment elevation myocardial infarction measured with phase-contrast cardiac magnetic resonance imaging

“…Late enhancement (LE) CMR images were acquired by using an ECG-triggered phase-sensitive inversion recovery (PSIR) single shot TrueFISP sequence with consecutive short-axis slices, as described in detail previously [27][28][29][30].…”