CLINICAL RESEARCH
Relationship of contractile function to transmural extent of infarction in patients with chronic coronary artery disease
Heiko Mahrholdt, MD*,
Anja Wagner, MD*,
Michele Parker, MS, RN ,
Matthias Regenfus, MD*,
David S. Fieno, PhD ,
Robert O. Bonow, MD, FACC*,
Raymond J. Kim, MD, FACC* and
Robert M. Judd, PhD*,*
* Feinberg Cardiovascular Research Institute, Chicago, IllinoisUSA
Departments of Medicine, Northwestern University Medical School, Chicago, Illinois USA
Biomedical Engineering, Northwestern University Medical School, Chicago, Illinois, USA
Manuscript received July 26, 2002;
revised manuscript received March 11, 2003,
accepted April 30, 2003.
* Reprint requests and correspondence: Dr. Robert M. Judd, Duke Cardiovascular Magnetic Resonance Center, Duke University Health System, P.O. Box 3934, Durham, North Carolina 27710, USA.
Robert.Judd{at}dcmrc.mc.duke.edu
OBJECTIVES: We sought to determine the relationship of contractile function to the transmural extent of infarction (TEI) in patients with chronic coronary artery disease.
BACKGROUND: In the setting of reperfused, chronic myocardial infarction (MI), the relationship of contractile function to the TEI has not been established.
METHODS: We studied function by cine magnetic resonance imaging (MRI) and the TEI by contrast-enhanced MRI in 31 patients with single-vessel disease 162 ± 62 days after reperfused first MI.
RESULTS: Of all 516 segments with MI, blinded observers were unable to detect abnormal thickening in 193 (37%), and wall thickening measured quantitatively in these segments was 66 ± 28%. Of the 193 segments, 163 (84%) were infarcts limited to the subendocardium. The average TEI reached 53% before half of the patients had abnormal contractile function. When patients with small MI ( 5% of total left ventricular [LV] mass) were excluded, the average TEI reached 43% before half the patients had abnormal function. In subjects with small MI (5% of total LV mass [n = 13]), even segments with TEI >75% had normal function (14 of 14) because they were surrounded by normally moving neighbor segments.
CONCLUSIONS: In the setting of reperfused chronic MI, the TEI approaches 50% before contractile dysfunction can be systematically identified. Contractile function cannot be used to rule out chronic MI.
|
Abbreviations and Acronyms
| | ceMRI | | contrast-enhanced magnetic resonance imaging | | LAX | | long axis | | LV | | left ventricle/ventricular | | MI | | myocardial infarction | | MR | | magnetic resonance | | MRI | | magnetic resonance imaging | | SAX | | short axis | | TEI | | transmural extent of infarction | | WM | | wall motion | | WT | | wall thickening |
|
This article has been cited by other articles:
|
|
|
|
 
H. Thibault, L. Gomez, E. Donal, G. Pontier, M. Scherrer-Crosbie, M. Ovize, and G. Derumeaux
Acute myocardial infarction in mice: assessment of transmurality by strain rate imaging
Am J Physiol Heart Circ Physiol,
July 1, 2007;
293(1):
H496 - H502.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. P. McCann, C. T. Gan, A. M. Beek, H. W. M. Niessen, A. V. Noordegraaf, and A. C. van Rossum
Extent of MRI Delayed Enhancement of Myocardial Mass Is Related to Right Ventricular Dysfunction in Pulmonary Artery Hypertension
Am. J. Roentgenol.,
February 1, 2007;
188(2):
349 - 355.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H Mahrholdt, I Klem, and U Sechtem
Cardiovascular MRI for detection of myocardial viability and ischaemia
Heart,
January 1, 2007;
93(1):
122 - 129.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. A. White, R. Yee, X. Yuan, A. Krahn, A. Skanes, M. Parker, G. Klein, and M. Drangova
Delayed Enhancement Magnetic Resonance Imaging Predicts Response to Cardiac Resynchronization Therapy in Patients With Intraventricular Dyssynchrony
J. Am. Coll. Cardiol.,
November 21, 2006;
48(10):
1953 - 1960.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Buckberg
Editorial comment: Left ventricular reconstruction for dilated ischemic cardiomyopathy: biology, registry, randomization, and credibility
Eur. J. Cardiothorac. Surg.,
November 1, 2006;
30(5):
759 - 761.
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. A. de Oliveira, L. H. W. Gowdak, G. Buckberg, J. E. Krieger, and the RESTORE Group
Cell biology, MRI and geometry: insight into a microscopic/macroscopic marriage
Eur. J. Cardiothorac. Surg.,
April 1, 2006;
29(Suppl_1):
S259 - S265.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Ishida, H. Sakuma, N. Kato, N. Ishida, K. Kitagawa, T. Shimono, I. Yada, and K. Takeda
Contrast-enhanced MR Imaging for Evaluation of Coronary Artery Disease before Elective Repair of Aortic Aneurysm
Radiology,
November 1, 2005;
237(2):
458 - 464.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Mahrholdt, A. Zhydkov, S. Hager, G. Meinhardt, H. Vogelsberg, A. Wagner, and U. Sechtem
Left ventricular wall motion abnormalities as well as reduced wall thickness can cause false positive results of routine SPECT perfusion imaging for detection of myocardial infarction
Eur. Heart J.,
October 2, 2005;
26(20):
2127 - 2135.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. D. Buckberg
Questions and answers about the STICH trial: A different perspective
J. Thorac. Cardiovasc. Surg.,
August 1, 2005;
130(2):
245 - 249.
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. Fuster and R. J. Kim
Frontiers in Cardiovascular Magnetic Resonance
Circulation,
July 5, 2005;
112(1):
135 - 144.
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y. Ichikawa, H. Sakuma, N. Suzawa, K. Kitagawa, K. Makino, T. Hirano, and K. Takeda
Late gadolinium-enhanced magnetic resonance imaging in acute and chronic myocardial infarction: Improved prediction of regional myocardial contraction in the chronic state by measuring thickness of nonenhanced myocardium
J. Am. Coll. Cardiol.,
March 15, 2005;
45(6):
901 - 909.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. J. Taylor, N. Al-Saadi, H. Abdel-Aty, J. Schulz-Menger, D. R. Messroghli, and M. G. Friedrich
Detection of Acutely Impaired Microvascular Reperfusion After Infarct Angioplasty With Magnetic Resonance Imaging
Circulation,
May 4, 2004;
109(17):
2080 - 2085.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
