Myocardium at Risk in St-Elevation Myocardial Infarction: Comparison of T2-Weighted Edema Imaging With the Endocardial Surface Area Assessed by Magnetic Resonance and Validation Against Angiographic Scoring

Fuernau, Georg; Eitel, Ingo; Franke, Vinzenz; Hildebrandt, Lysann; Meissner, Josefine; Waha, Suzanne de; Lurz, Philipp; Gutberlet, Matthias; Desch, Steffen; Schuler, Gerhard; Thiele, Holger

doi:10.1016/s0735-1097(11)60734-1

Cited by 5 publications

(5 citation statements)

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“…The "bright blood" T2W-steady-state free precession sequences take advantage of improved coil sensitivity normalization and faster imaging. So far, T2W-STIR sequences are the only edema imaging sequences ever to be validated against pathology (21) and to have their prognostic value established in patients with reperfused acute myocardial infarction (8,28,34,35). In the future, T2 mapping techniques will probably solve most of the remaining issues (36).…”

Section: Volumes and Massmentioning

confidence: 99%

Post-Conditioning Reduces Infarct Size and Edema in Patients With ST-Segment Elevation Myocardial Infarction

Thuny

Lairez

Roubille

et al. 2012

Journal of the American College of Cardiology

206

162

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Section: Volumes and Massmentioning

confidence: 99%

Post-Conditioning Reduces Infarct Size and Edema in Patients With ST-Segment Elevation Myocardial Infarction

Thuny

Lairez

Roubille

et al. 2012

Journal of the American College of Cardiology

206

162

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“…Recent animal data have confirmed an excellent agreement of findings in T2-weighted images with pathology in early reperfused MI (2). The amount of peri-infarct edema in clinical studies, however, varies significantly (3) and thus needs to be further studied.…”

Section: R E P L Ymentioning

confidence: 82%

T2-Weighted CMR

Mewton¹,

Thuny²,

Croisille³

2012

JACC: Cardiovascular Imaging

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28.0% vs. 14.9 Ϯ 23.6%, p Ͻ 0.01) compared with the nonfractured stent group. The absence of stent strut was the common morphological feature of stent fracture in OCT. Both mean and maximal neointimal area were larger in the stent fracture group (fracture 1.59 Ϯ 0.75 mm 2 vs. nonfracture 0.55 Ϯ 0.46 mm 2 , p Ͻ 0.01; and fracture 3.30 Ϯ 1.73 mm 2 vs. nonfracture 1.28 Ϯ 1.10 mm 2 , p Ͻ 0.01, respectively). Although neointima grew equally in the nonfractured stent group, the distribution of neointimal area showed a peak at the fracture site in the fractured stent group (Fig. 2). The longitudinal length of the absence of stent struts was positively correlated with the neointimal area at the fracture site (r ϭ 0.79, p Ͻ 0.01). From the receiver-operating characteristics curve, the best cutoff value of the length of the absence of stent struts to diagnose stent fracture was 1.07 mm (area under the curve 0.85, sensitivity 93%, and specificity 80%).The absence of stent strut was the common morphological feature of stent fracture, and its length was correlated with the neointimal area. These results suggest that the loss of stent strut itself is one of the important contributors to excessive neointimal growth. Previous ex vivo studies reported that cyclic stretch on cultured cells induces the proliferation of vascular smooth muscle cells. We have reported that stent fracture frequently occurs at bend lesions (4). When stent fracture occurs, the stent loses its ability to scaffold the artery wall against mechanical stress. We speculate that occurrence of these mechanical stresses at the fracture site could contribute to excessive neointimal growth. Furthermore, many previous studies have postulated other causes for SES restenosis including stent under-expansion, polymer disruption, stent strut inconsistent distribution, and stent fracture. These factors could directly or indirectly affect the drug delivery. Even though it is difficult to know when the stent was fractured, we speculate that a loss of stent struts at the fracture site may impede effective local drug delivery, resulting in failure to prevent the neointimal growth.

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“…This method has shown excellent correlation (r = 0.90) to at risk myocardium estimated angiographically using the Myocardial Jeopardy Index [101], but other studies did not find favorable results using this approach [102,103], probably because ESA would underestimate the myocardial salvage in aborted infarctions [102]. Fuernau et al [102] showed a good correlation between AAR estimated by T2W images and angiography (r = 0.87), but only modest correlation between ESA and angiographically estimated AAR (r = 0.44). Previous studies supported the use of T2W images in the identification of ACSs in the emergency department.…”

Section: Quantification Of Myocardial Area At Risk and Myocardial Salmentioning

confidence: 92%

Myocardial infarction

Flotats

Gerber

Gurunathan

et al. 2015

Advanced Cardiac Imaging

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Myocardium at Risk in St-Elevation Myocardial Infarction: Comparison of T2-Weighted Edema Imaging With the Endocardial Surface Area Assessed by Magnetic Resonance and Validation Against Angiographic Scoring

Cited by 5 publications

References 0 publications

Post-Conditioning Reduces Infarct Size and Edema in Patients With ST-Segment Elevation Myocardial Infarction

Post-Conditioning Reduces Infarct Size and Edema in Patients With ST-Segment Elevation Myocardial Infarction

T2-Weighted CMR

Myocardial infarction

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