HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: j.jacc.2006.05.041v1 48/4/765    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ebeling Barbier, C. Articles by Ahlström, H. Search for Related Content PubMed PubMed Citation Articles by Ebeling Barbier, C. Articles by Ahlström, H.

CLINICAL RESEARCH: CARDIAC IMAGING

Myocardial Scars More Frequent Than Expected

Magnetic Resonance Imaging Detects Potential Risk Group

Charlotte Ebeling Barbier, MD^_*,_*, Tomas Bjerner, MD, PhD^_*, Lars Johansson, PhD^_*,, Lars Lind, MD, PhD^, and Håkan Ahlström, MD, PhD^_*

^_* Department of Radiology, Uppsala University Hospital, Uppsala, Sweden
AstraZeneca, Gothenburg, Sweden
Department of Medicine, Uppsala University Hospital, Uppsala, Sweden.

Manuscript received March 3, 2006; revised manuscript received April 7, 2006, accepted April 17, 2006.

^_* Reprint requests and correspondence: Dr. Charlotte Ebeling Barbier, The Department of Radiology, Uppsala University Hospital, 751 85 Uppsala, Sweden. (Email: Charlotte.Ebeling_Barbier{at}radiol.uu.se).

OBJECTIVES: The aim of this study was to investigate the prevalence of clinically recognized myocardial infarctions (RMIs) and unrecognized myocardial infarctions (UMIs) in 70-year-old subjects, assessed with magnetic resonance imaging (MRI), and to relate the findings to cardiac function and morbidity.

BACKGROUND: Late enhancement MRI identifies myocardial scars and thereby has the potential to detect UMI.

METHODS: Cardiac MRI was performed on 259 randomly chosen 70-year-old subjects. Late enhancement and cine sequences were acquired, and the ejection fraction and left ventricular (LV) mass were calculated. Late enhancement involving the subendocardial layer was considered to represent myocardial infarction (MI) scars, and their volumes were calculated. Information on cardiac morbidity and risk factors was collected from medical records and from a health examination. Subjects with MI scars, with or without a hospital diagnosis of MI were classified as RMI or UMI, respectively.

RESULTS: The images from 248 subjects (123 women, 125 men) were assessable. Myocardial infarction scars were found in 60 subjects (24.2%), in 49 of whom (19.8%) they were UMIs. The volumes of the UMIs were significantly smaller than those of the RMIs. There was an increased frequency of chest pain symptoms among the subjects with UMI or RMI compared with those without MI scars. Ejection fraction was significantly lower and LV mass significantly larger in the subjects with UMI or RMI than in those without MI scars.

CONCLUSIONS: Unrecognized MI detected with MRI was more frequent than expected in 70-year-old subjects. The subjects displaying these UMIs may represent a previously unknown potential risk group for future cardiovascular events.

Abbreviations and Acronyms   CHF = congestive heart failure   EF = ejection fraction   LV = left ventricle/ventricular   MI = myocardial infarction   MRA = magnetic resonance angiography   MRI = magnetic resonance imaging   PIVUS = Prospective Investigation of the Vasculature in Uppsala Seniors study   RMI = recognized myocardial infarction   UMI = unrecognized myocardial infarction

This article has been cited by other articles:

				B. Zethelius, L. Berglund, J. Sundstrom, E. Ingelsson, S. Basu, A. Larsson, P. Venge, and J. Arnlov Use of Multiple Biomarkers to Improve the Prediction of Death from Cardiovascular Causes N. Engl. J. Med., May 15, 2008; 358(20): 2107 - 2116. [Abstract] [Full Text] [PDF]

				C. Ebeling Barbier, T. Bjerner, T. Hansen, J. Andersson, L. Lind, J. Hulthe, L. Johansson, and H. Ahlstrom Clinically Unrecognized Myocardial Infarction Detected at MR Imaging May Not Be Associated with Atherosclerosis Radiology, October 1, 2007; 245(1): 103 - 110. [Abstract] [Full Text] [PDF]

				B. D. Rosen, M. Cushman, K. Nasir, D. A. Bluemke, T. Edvardsen, V. Fernandes, S. Lai, R. P. Tracy, and J. A.C. Lima Relationship Between C-Reactive Protein Levels and Regional Left Ventricular Function in Asymptomatic Individuals: The Multi-Ethnic Study of Atherosclerosis J. Am. Coll. Cardiol., February 6, 2007; 49(5): 594 - 600. [Abstract] [Full Text] [PDF]

				A. N. DeMaria, O. Ben-Yehuda, G. K. Feld, G. S. Ginsburg, B. H. Greenberg, W. Y.W. Lew, J. A.C. Lima, A. S. Maisel, J. Narula, D. J. Sahn, et al. Highlights of the Year in JACC 2006 J. Am. Coll. Cardiol., January 30, 2007; 49(4): 509 - 527. [Full Text] [PDF]

				A. S. Jaffe, L. Babuin, and F. S. Apple Reply J. Am. Coll. Cardiol., December 5, 2006; 48(11): 2358 - 2359. [Full Text] [PDF]