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Usefulness of a Comprehensive Cardiovascular Magnetic Resonance Imaging Assessment for Predicting Recovery of Left Ventricular Wall Motion in the Setting of Myocardial Stunning

Vicente Bodí, MD, FESC^_*,_*, Juan Sanchis, MD, FESC^_*, María P. López-Lereu, MD, Antonio Losada, MD^_*, Julio Núñez, MD^_*, Mauricio Pellicer, MD^_*, Vicente Bertomeu, MD^_*, Francisco J. Chorro, MD, FESC^_* and Àngel Llácer, MD, FESC^_*

^_* Cardiology Department, Hospital Clínico y Universitario de Valencia, Universidad de Valencia, Valencia, Spain
Cardiovascular Magnetic Resonance Imaging Unit, ERESA, Valencia, Spain.

View larger version (15K): [in a new window]   Figure 1 Percentage of segments with normal wall motion (WM) at the sixth month (wall thickening >2 mm) depending on the five-level comprehensive score. Viability indexes: wall thickness >5.5 mm, normal perfusion, wall thickening during low-dose dobutamine >2 mm, and transmural extent of necrosis <50%. In Level 2, wall thickness >5.5 mm and/or normal perfusion should be present. – = index absent; + = index present; +/– = index may be present or absent.

View larger version (171K): [in a new window]   Figure 2 Cardiovascular magnetic resonance imaging allowed a simultaneous assessment of four viability indexes in the same session. (Upper panels) Using cine-images, end-diastolic wall thickness and wall thickening during low-dose dobutamine infusion were quantified. (Lower panels) Example of a patient with an anterior infarction showing a perfusion defect (left) and transmural necrosis (right) in the anterior territory.