Perfusion MRI at rest in subacute and chronic myocardial infarct

Hopp, Einar; Bjørnerud, Atle; Lunde, Ketil; Solheim, Svein; Aakhus, Svend; Arnesen, Harald; Forfang, Kolbjørn; Edvardsen, Thor; Smith, Hans‐Jørgen

doi:10.1177/0284185113475605

Cited by 4 publications

(4 citation statements)

References 49 publications

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“…In the present study, patients with high MCE injured myocardium performed better on functional CMR parameters and presented with significantly smaller IS, and even though they had smaller AaR, they also had higher myocardial salvage. This is in agreement with the findings of Hopp et al [ 7 ], who also found a correlation between peak enhancement in the infarcted myocardium and the presence of MVO at LGE. Ørn et al also demonstrated larger infarct sizes at six months in the presence of impaired first-pass perfusion [ 33 ].…”

Section: Discussionsupporting

confidence: 93%

“…We applied a semiquantitative analysis for the evaluation of first-pass perfusion imaging instead of analyzing the absolute values. However, semiquantitative approaches have been shown to be valuable in STEMI patients [ 7 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

“…Cardiac magnetic resonance (CMR) imaging is a sensitive method for evaluation of the microcirculation with high spatial resolution [ 6 , 7 ]. Over the last two decades CMR imaging has been used in STEMI patients to evaluate treatment and to predict and measure final outcome after the infarction [ 8 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

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MR findings of microvascular perfusion in infarcted and remote myocardium early after successful primary PCI

et al. 2018

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ObjectivesThe aim of the study was to evaluate CMR myocardial first-pass perfusion in the injured region as well as the non-infarcted area in ST-elevation myocardial infarction (STEMI) patients few days after successful primary percutaneous coronary intervention (PCI).Materials and methods220 patients with first time STEMI successfully treated with PCI (with or without postconditioning) were recruited from the Postconditioning in STEMI study. Contrast enhanced CMR was performed at a 1.5 T scanner 2 (1–5) days after PCI. On myocardial first-pass perfusion imaging signal intensity (SI) was measured in the injured area and in the remote myocardium and maximum contrast enhancement index (MCE) was calculated. MCE = (peak SI after contrast—SI at baseline) / SI at baseline x 100.ResultsThere were no significant differences in first-pass perfusion between patients treated with standard PCI and patients treated with additional postconditioning. The injured myocardium showed a significantly lower MCE compared to remote myocardium (94 ± 55 vs. 113 ± 49; p < 0.001). When patients were divided into four quartiles of MCE in the injured myocardium (MCE injured myocardium), patients with low MCE injured myocardium had: significantly lower ejection fraction (EF) than patients with high MCE injured myocardium, larger infarct size and area at risk, smaller myocardial salvage and more frequent occurrence of microvascular obstruction on late gadolinium enhancement. MCE in the remote myocardium revealed that patients with larger infarction also had significantly decreased MCE in the non-infarcted, remote area.ConclusionCMR first-pass perfusion can be impaired in both injured and remote myocardium in STEMI patients treated with primary PCI. These findings indicate that CMR first-pass perfusion may be a feasible method to evaluate myocardial injury after STEMI in addition to conventional CMR parameters.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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MR findings of microvascular perfusion in infarcted and remote myocardium early after successful primary PCI

et al. 2018

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“…In addition, CMRImeasured semi-quantitative myocardial perfusion has shown good correlation to quantitative CMRI-measured myocardial perfusion, rubidium-82 positron emission tomography and to 320-multidetector computed tomography-measured qualitative myocardial perfusion [17][18][19] . However, in scar tissue the slope derived from the time-signal curve after injecting contrast is decreased compared with normal tissue due to reduced blood perfusion 20 .…”

Section: Discussionmentioning

confidence: 98%

Cardiac Magnetic Resonance Imaging used for Evaluation of Adipose-Derived Stromal Cell Therapy in Patients with Chronic Ischemic Heart Disease

et al. 2019

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Adipose-derived stromal cell (ASC) therapy is currently investigated as a new treatment option for patients with ischemic heart disease (IHD). The aim of this study was to evaluate the effect of ASC therapy in patients with chronic IHD measuring myocardial perfusion and cardiac function using cardiac magnetic resonance imaging (CMRI). Patients were included in MyStromalCell trial, a phase II, randomized, double-blinded, placebo-controlled study investigated the effect of ASCs in patients with chronic IHD with preserved left ventricular ejection fraction (LVEF). In total, 41 of 60 patients underwent cine, late enhancement, rest and stress imaging with CMRI. There was a non-significant difference between stress and rest values in maximal signal intensity, a measure of myocardial perfusion, from baseline to follow-up comparing placebo with ASC group (–52.52 ± 88.61 and 3.05 ± 63.17, p = 0.061, respectively). LVEF, myocardial mass, stroke volume, left ventricle end-diastolic volume and end-systolic volume changed non-significantly (–0.5 ± 4.7%, –3.5 ± 13.1 g, –0.7 ± 8.6 mL, 1.9 ± 25.1 mL and 2.6 ± 16.5 mL, respectively) in the placebo group and in the ASC group (0.7 ± 8.6%, 0.9 ± 10.8 g, –0.3 ± 26.1 mL, –3.0 ± 31.5 mL and –2.7 ± 20.4 mL, respectively) from baseline to 6 months follow-up. The amount of scar tissue was unchanged in the placebo group by 0.0 ± 1.6 g, p = 1.0 and in the ASC group with –0.3 ± 2.3 g, p = 0.540. There was no difference between the groups. There was a non-significant trend toward increased myocardial perfusion but no significant changes in functional parameters or amount of scar tissue in patients treated with ASCs compared with patients allocated into the placebo group.

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Microvascular perfusion in infarcted and remote myocardium after successful primary PCI: angiographic and CMR findings

Bethke

Limalanathan²,

Andersen

et al. 2018

Eur Radiol

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• Cardiac magnetic resonance myocardial first-pass perfusion and TMP grading after successful PCI helps to assess risk in patients with ST elevation myocardial infarction. • Cardiac magnetic resonance myocardial first-pass perfusion shows that microvascular perfusion after ST elevation myocardial infarction can be impaired in both infarcted and non-infarcted myocardium. • Microvascular perfusion improves over time in patients with ST elevation myocardial infarction treated with primary PCI.

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Perfusion MRI at rest in subacute and chronic myocardial infarct

Cited by 4 publications

References 49 publications

MR findings of microvascular perfusion in infarcted and remote myocardium early after successful primary PCI

MR findings of microvascular perfusion in infarcted and remote myocardium early after successful primary PCI

Cardiac Magnetic Resonance Imaging used for Evaluation of Adipose-Derived Stromal Cell Therapy in Patients with Chronic Ischemic Heart Disease

Microvascular perfusion in infarcted and remote myocardium after successful primary PCI: angiographic and CMR findings

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