Imaging the Area at Risk in Myocardial Infarction With Cardiovascular Magnetic Resonance

Schelbert, Erik B.; Wong, Timothy C.

doi:10.1161/jaha.114.001253

Cited by 4 publications

(1 citation statement)

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“…By the histologic measurement of SM in animal models it was possible to identify several factors related to the spreading of the necrosis [2,3,4], acquiring information that had an impact on clinical practice. In vivo, several imaging techniques have been developed for the SM assessment, all of them relying on the assessment of the AAR and final infarct size (IS), while SM is obtained by their difference [5,6]. Coronary angiography can be used to detect the AAR only, whereas echocardiography and cardiac computed tomography are less used for this purpose due to their inherent limitations (i.e.…”

Section: Introductionmentioning

confidence: 99%

Myocardial Salvage Imaging: Where Are We and Where Are We Heading? A Cardiac Magnetic Resonance Perspective

Arcari

Bucciarelli-Ducci

Francone

et al. 2018

Curr Cardiovasc Imaging Rep

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Purpose of review: cardiac magnetic resonance (CMR) has emerged in recent years as a reliable tool to assess, in a single examination after a reperfused myocardial infarction, the initially area at risk (AAR), the final infarct size (IS) and from their difference the salvaged myocardium (SM). The aim of the present review is to summarize recent advances in the CMR imaging of SM. Recent findings: while there is consensus on the use of late gadolinium enhancement (LGE) to calculate IS, how to assess the AAR is a debated topic. The use of T2 weighted short-TI inversion recovery (T2W-STIR) is to date supported by a large amount of data, but it is affected by several limitations. Newer techniques have been developed to overcome T2W-STIR limitations, some of them have been already used in randomized clinical trials (RCTs) while others are showing promising results. The use of CMR to generate surrogate endpoints in RCTs is gaining attention; in this context, analyses of data from recent RCTs suggests that the assessment of SM as outcome measure could be useful to reduce sample sizes and costs of trials. Summary: CMR is a reliable technique for the assessment of SM. LGE is the gold standard for IS measurement, while which is the best technique for the evaluation of AAR is still debated. When using CMR-derived endpoints in RCTs, the assessment of SM is advisable.

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