Cardiovascular magnetic resonance imaging of myocardial oedema following acute myocardial infarction: Is whole heart coverage necessary?

Hamshere, Stephen; Jones, Daniel A.; Pellaton, Cyril; Longchamp, Danielle; Burchell, Thomas; Mohiddin, Saidi A.; Moon, James; Kastrup, Jens; Locca, Didier; Petersen, Steffen E.; Westwood, Mark; Mathur, Anthony

doi:10.1186/s12968-016-0226-5

Cited by 11 publications

(11 citation statements)

References 21 publications

(20 reference statements)

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“…It has been suggested that to avoid this bias, one could use a multislice technique. 40 Third, the CMR 1 was later on the control group so edema could not be present just because it was done later than the liraglutide group. The number of patients could be increased to try to minimize this effect.…”

Section: Study Limitationsmentioning

confidence: 99%

Effects of Liraglutide on Reperfusion Injury in Patients With ST-Segment–Elevation Myocardial Infarction

Chen

Tian

et al. 2016

Circ: Cardiovascular Imaging

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A cute ST-segment-elevation myocardial infarction (STEMI) is a leading cause of mortality and morbidity. Primary percutaneous coronary intervention (pPCI) is currently the most effective treatment strategy for STEMI. 1 However, acute restoration of myocardial blood flow may in itself jeopardize the cardiomyocytes. This phenomenon, known as reperfusion injury, may account for as much as 50% of the final myocardial infarct size, 2 a major determinant of the prognosis in patients with STEMI. 3 To date, few drugs have been shown to protect the heart during reperfusion. See Editorial by Flather See Clinical PerspectiveElevation of blood glucose is a common metabolic disorder among patients with acute myocardial infarction (AMI) and is associated with an adverse prognosis.5 Glucagon-like peptide-1 (GLP-1) is an incretin hormone that regulates plasma glucose. GLP-1 may have antioxidant and anti-inflammatory properties and protect endothelial function. 6 Experimental studies have also revealed that GLP-1 or its analogs protect against reperfusion injury in pigs. 7 Liraglutide, a GLP-1 analog, was reported to reduce infarct size and improve cardiac output in normal and diabetic mice. 8 Several studies have shown that exenatide (another GLP-1 analog) protects against ischemia-reperfusion injury and reduces infarct size in patients with STEMI. 9,10 In our previous study, liraglutide could improve left ventricular (LV) function and reduce no-reflow in patients with AMI.11 No-reflow after AMI is an important predictor of infarct size and clinical outcome.12 However, the effects of liraglutide on infarct size in STEMI patients remain unclear. The aim of this study was to investigate the effects of liraglutide on myocardial salvage and infarct size using cardiac magnetic resonance (CMR) methods.Background-Liraglutide, a glucagon-like peptide-1 analog, was reported to reduce reperfusion injury in mice. We planned to evaluate the effects of liraglutide on reperfusion injury in patients with acute ST-segment-elevation myocardial infarction treated with primary percutaneous coronary intervention. Methods and Results-A total of 96 patients with ST-segment-elevation myocardial infarction undergoing emergency primary percutaneous coronary intervention were randomized to receive either subcutaneous liraglutide or placebo. Study treatment was commenced 30 minutes before intervention (1.8 mg) and maintained for 7 days after the procedure (0.6 mg for 2 days, 1.2 mg for 2 days, followed by 1.8 mg for 3 days). The salvage index was calculated from myocardial area at risk, measured during the index admission (35±12 hours), and final infarct size measured at 91±5 days after primary percutaneous coronary intervention by cardiac magnetic resonance. At 3 months, the primary end point, a higher salvage index was found in the liraglutide group than in the placebo group in 77 patients evaluated with cardiac magnetic resonance (0.66±0.14 versus 0.55±0.15; P=0.001). The final infarct size was lower in the liraglutide group than that in the placebo ...

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Section: Study Limitationsmentioning

confidence: 99%

Effects of Liraglutide on Reperfusion Injury in Patients With ST-Segment–Elevation Myocardial Infarction

Chen

Tian

et al. 2016

Circ: Cardiovascular Imaging

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“…Furthermore, when MSI was calculated using whole LV coverage for MI size and the 3 slices for AAR as previously done by Hamshere et al . 12 , this approach underestimated the AAR in 7/48 patients for T2 mapping and 3/30 patients for T1 mapping and resulted in a negative MSI, which is not plausible in practice and would impact on mean MSI in a cardioprotection study. In the clinical setting, it is difficult to know whether a patient would have MSI more than or less than 0.50 prior to acquiring the images and the analysis the MI size and AAR data and therefore full LV acquisition of T1 or T2 maps is recommended when the edema-based AAR needs to be assessed.…”

Section: Discussionmentioning

confidence: 95%

“…The accurate quantification of the AAR conventionally requires full left ventricular (LV) coverage. Recently, a 3-slice approach has been proposed for T2-weighted STIR imaging, with the obvious benefit of shorter scan and analysis time 12 . The main aim of this study was to assess whether the 3-slice approach will also perform as well as full LV coverage, using T1 and T2 mapping to delineate the AAR.…”

Section: Introductionmentioning

confidence: 99%

Full left ventricular coverage is essential for the accurate quantification of the area-at-risk by T1 and T2 mapping

Bulluck

Bryant

Lim

et al. 2017

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T2-weighted cardiovascular magnetic resonance (CMR) using a 3-slice approach has been shown to accurately quantify the edema-based area-at-risk (AAR) in ST-segment elevation myocardial infarction (STEMI). We aimed to compare the performance of a 3-slice approach to full left ventricular (LV) coverage for the AAR by T1 and T2 mapping and MI size. Forty-eight STEMI patients were prospectively recruited and underwent a CMR at 4 ± 2 days. There was no difference between the AARfull LV and AAR3-slices by T1 (P = 0.054) and T2-mapping (P = 0.092), with good correlations but small biases and wide limits of agreements (T1-mapping: N = 30, R2 = 0.85, bias = 1.7 ± 9.4% LV; T2-mapping: N = 48, R2 = 0.75, bias = 1.7 ± 12.9% LV). There was also no significant difference between MI size3-slices and MI sizefull LV (P = 0.93) with an excellent correlation between the two (R2 0.92) but a small bias of 0.5% and a wide limit of agreement of ±7.7%. Although MSI was similar between the 2 approaches, MSI3-slices performed poorly when MSI was <0.50. Furthermore, using AAR3-slices and MI sizefull LV resulted in ‘negative’ MSI in 7/48 patients. Full LV coverage T1 and T2 mapping are more accurate than a 3-slice approach for delineating the AAR, especially in those with MSI < 0.50 and we would advocate full LV coverage in future studies.

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“…The area-at-risk is useful when assessing the efficacy of reperfusion therapy and novel cardioprotective agents after myocardial infarction. In this study by Hamshere and co-workers [ 79 ], CMR was performed in 167 patients after successful primary percutaneous coronary intervention with 82 patients undergoing a novel 3-short axis T2-STIR protocol and 85 both the novel 3-short axis protocol and a conventional 10 slice short-axis late gadolinium enhancement (LGE) protocol. The 3-slice T2-STIR and 10 slice LGE area-at-risk imaging showed a strong correlation with each other and with the angiographic risk scores.…”

Section: Cardiomyopathiesmentioning

confidence: 99%

Review of Journal of Cardiovascular Magnetic Resonance (JCMR) 2015-2016 and transition of the JCMR office to Boston

Manning

2016

Journal of Cardiovascular Magnetic Resonance

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The Journal of Cardiovascular Magnetic Resonance (JCMR) is the official publication of the Society for Cardiovascular Magnetic Resonance (SCMR). In 2016, the JCMR published 93 manuscripts, including 80 research papers, 6 reviews, 5 technical notes, 1 protocol, and 1 case report. The number of manuscripts published was similar to 2015 though with a 12% increase in manuscript submissions to an all-time high of 369. This reflects a decrease in the overall acceptance rate to <25% (excluding solicited reviews). The quality of submissions to JCMR continues to be high. The 2016 JCMR Impact Factor (which is published in June 2016 by Thomson Reuters) was steady at 5.601 (vs. 5.71 for 2015; as published in June 2016), which is the second highest impact factor ever recorded for JCMR. The 2016 impact factor means that the JCMR papers that were published in 2014 and 2015 were on-average cited 5.71 times in 2016.In accordance with Open-Access publishing of Biomed Central, the JCMR articles are published on-line in the order that they are accepted with no collating of the articles into sections or special thematic issues. For this reason, over the years, the Editors have felt that it is useful to annually summarize the publications into broad areas of interest or themes, so that readers can view areas of interest in a single article in relation to each other and other recent JCMR articles. The papers are presented in broad themes with previously published JCMR papers to guide continuity of thought in the journal. In addition, I have elected to open this publication with information for the readership regarding the transition of the JCMR editorial office to the Beth Israel Deaconess Medical Center, Boston and the editorial process.Though there is an author publication charge (APC) associated with open-access to cover the publisher’s expenses, this format provides a much wider distribution/availability of the author’s work and greater manuscript citation. For SCMR members, there is a substantial discount in the APC. I hope that you will continue to send your high quality manuscripts to JCMR for consideration. Importantly, I also ask that you consider referencing recent JCMR publications in your submissions to the JCMR and elsewhere as these contribute to our impact factor. I also thank our dedicated Associate Editors, Guest Editors, and reviewers for their many efforts to ensure that the review process occurs in a timely and responsible manner and that the JCMR continues to be recognized as the leading publication in our field.

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Cardiovascular magnetic resonance imaging of myocardial oedema following acute myocardial infarction: Is whole heart coverage necessary?

Cited by 11 publications

References 21 publications

Effects of Liraglutide on Reperfusion Injury in Patients With ST-Segment–Elevation Myocardial Infarction

Effects of Liraglutide on Reperfusion Injury in Patients With ST-Segment–Elevation Myocardial Infarction

Full left ventricular coverage is essential for the accurate quantification of the area-at-risk by T1 and T2 mapping

Review of Journal of Cardiovascular Magnetic Resonance (JCMR) 2015-2016 and transition of the JCMR office to Boston

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