Work

Left ventricular remodeling after reperfused acute myocardial infarction: insights from automated ECV mapping

Year: 2016

Type: article

Abstract: In reperfused acute ST-segment elevation myocardial infarction (STEMI), infarct size and microvascular obstruction (MVO) are strong predictors of adverse LV remodeling and poor outcome. However, the role of remote myocardium is less clear. Remote native T1 changes have been linked with adverse LV remodeling and is thought to be associated with inflammation. We used automated ECV mapping to provide further insights into the pathophysiology of LV remodeling. 40 STEMI patients underwent CMR imaging at 1.5T (Avanto, Siemens), 4 ± 2 days post primary percutaneous coronary intervention and at 5 ± 2 months. Left ventricular (LV) short-axis native and post-contrast T1 (MOLLI) and T2 maps were acquired, and automated ECV maps generated (motion-corrected and co-registered). Mean segmental T2, T1 and ECV values were obtained as per the AHA model (CVI42, Calgary, Canada) (Fiure 1). Apical slices were excluded to avoid partial voluming errors. LV remodeling was defined as 20% increases in LV end-diastolic volume on the follow-up scan. Salvaged myocardium was defined as regions of high T1/T2/ECV without LGE. 8/40(20%) patients had AR at follow-up.

Source: Journal of Cardiovascular Magnetic Resonance

DOI: 10.1186/1532-429x-18-s1-q67