Analysis of microvascularity after reperfused acute myocardial infarction using the maximum slope method of contrast-enhanced magnetic resonance imaging

Nagao, Michinobu; Hara, Hiroshi; Matsuoka, Hiroshi; Kawakami, Hideo; Mochizuki, Takashi; Uemura, Masahiko; Tokunaga, Nobuko; Murase, Kenya

doi:10.1007/s11604-008-0230-2

Cited by 2 publications

(1 citation statement)

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“…Furthermore, there was no evidence of other infarction on LGE. Non-culprit lesion or collateral flow reduction might cause deprived first-pass perfusion in the remote myocardium [ 16 , 41 ]. However, coronary stenosis do normally not reduce resting myocardial perfusion [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

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: Discussionmentioning

confidence: 99%

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

et al. 2018

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Patterns of myocardial perfusion in the acute and chronic stage after myocardial infarction: A cardiac magnetic resonance study

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et al. 2012

European Journal of Radiology

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Analysis of microvascularity after reperfused acute myocardial infarction using the maximum slope method of contrast-enhanced magnetic resonance imaging

Abstract: This study presents a method that directly assesses microvascularity after reperfused AMI.

Cited by 2 publications

References 30 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

Patterns of myocardial perfusion in the acute and chronic stage after myocardial infarction: A cardiac magnetic resonance study

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