Advances in Magnetic Resonance Imaging of the Myocardial Area at Risk and Salvage

Abstract

Cardiac magnetic resonance (CMR) imaging in survivors of acute ST-segment-elevation myocardial infarction (STEMI) provides accurate and precise measurements of left ventricular dimensions, and infarct pathologies are uniquely characterized. Acute coronary artery occlusion initiates a wavefront phenomenon of ischemia 1 commencing from the endocardial layer and propagating radially toward the epicardium, and typically, myocardial infarction will supervene unless coronary reperfusion is achieved in a timely manner. The myocardial area at risk is the jeopardized perfusion territory of the culprit artery.

Native T1 and T2 provide distinctive signatures in hypertrophic cardiac conditions – Comparison of uremic, hypertensive and hypertrophic cardiomyopathy

“…Interstitial diffuse myocardial fibrosis is a recognised pathophysiological factor; postmortem studies revealed 'diffuse non-coronary interstitial fibrosis' in most patients on haemodialysis (HD) and those with less severe CKD, but not in non-hypertensive, non-diabetic controls [4]. More recent studies with T1 mapping, a novel imaging marker of abnormal myocardium with cardiovascular magnetic resonance (CMR), reported raised values, providing a non-invasive means of in-vivo recognition of pathologic remodelling in CKD [5,6]. Yet, T1 mapping is a sensitive measure of myocardial pathology, it is non-specific with regards to the underlying substrate; in addition to fibrosis, it can also relate to myocardial oedema or infiltration [7].…”