Role of cardiac MRI in acute myocardial infarction

Erwin Mulia, Sony H. Wicaksono, Manoefris Kasim



DOI: https://doi.org/10.13181/mji.v22i1.513

Abstract


Mortality in patients with acute myocardial infarction (AMI) has decreased significantly and appears to be the result of current reperfusion therapeutic strategies. Reperfusion itself may develop into reperfusion injury. Therefore, management of these patients poses several challenges, such as diagnosing and managing heart failure, identifying persistent or inducible ischaemia, estimating the need for anticoagulation, and assessing overall cardiovascular risk. This case presentation will demonstrate the impact of cardiac magnetic resonance imaging (MRI) in the assessment of the pathophysiology of AMI in the current reperfusion era. Cardiac MRI can provide a wide range of clinically useful information which will help clinicians to manage and choose specific therapeutic strategies for AMI patients. (Med J Indones. 2013;22:46-53)

Keywords: Acute myocardial infarction, cardiac magnetic resonance imaging, reperfusion injury


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References


  1. Kuch B, Bolte HD, Hoermann A, et al. What is the real hospital mortality from acute myocardial infarction? Epidemiological vs clinical view. Eur Heart J. 2002;23:714–20.
  2. Fox KA, Steg PG, Eagle KA, et al. Decline in rates of death and heart failure in acute coronary syndromes, 1999–2006. JAMA. 2007;297:1892–900.
  3. Marra MP, Lima JAC, Iliceto S. MRI in acute myocardial infarction. Eur Heart J. 2011;32:284–93.
  4. Ganame J, Messalli G, Dymarkowski S, et al. Impact of myocardial hemorrhage of left ventricular function and remodelling in patients with reperfused acute myocardial infarction. Eur Heart J. 2009;30:1440–9.
  5. Flachskampf FA, Schmid M, Rost C, et al. Cardiac imaging after myocardial infarction. Eur Heart J. 2011;32:272–83.
  6. Grotheus F, Moon JCC, Bellenger NG, et al. Interstudy reproducibility of right ventricular volumes, function and mass with cardiovascular magnetic resonance. Am Heart J. 2004;147:218–23.
  7. Hundley WG, Bluemke DA, Finn JP, et al. ACCF/ACR/AHA/NASCI/SCMR 2010 Expert consensus document on cardiovascular magnetic resonance: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. J Am Coll Cardiol. 2010;55;2614–62.
  8. Plein S, Bloomer TN, Ridgway JP, et al. Steady-state free precession magnetic resonance imaging of the heart: comparison with segmented k-space gradient-echo imaging. J Magn Reson Imaging. 2001;14:230–6.
  9. Pennel DJ. Cardiovascular magnetic resonance. Circulation. 2010;121:692–705.
  10. Gotte MJ, Germans T, Russel IK, et al. Myocardial strain and torsion quantified by cardiovascular magnetic resonance tissue tagging: studies in normal and impaired left ventricular function. J Am Coll Cardiol. 2006;48:2002–11.
  11. Aletras AH, Tilak GS, Natanzon A, et al. Retrospective determination of the area at risk for reperfused acute myocardial infarction with T2-weighted cardiac magnetic resonance imaging: histopathological and displacement encoding with stimulated echos (DENSE) functional validations. Circulation. 2006;113:1865–70.
  12. Abdel-Aty H, Zagrosek A, Schulz-Menger J, et al. Delayed enhancement and T2-weighted cardiovascular magnetic resonance imaging differentiate acute from chronic myocardial infarction. Circulation. 2004;109:2411–6.
  13. Friedrich MG, Abdel-Aty H, Taylor A, et al. The salvaged area at risk in reperfused acute myocardial infarction as visualized by cardiovascular magnetic resonance. J Am Coll Cardiol. 2008;51:1581–7.
  14. Hombach V, Grebe O, Merkle N, et al. Sequelae of acute myocardial infarction regarding cardiac structure and function and their prognostic significance as assessed by magnetic resonance imaging. Eur Heart J. 2005;26:549–57.
  15. Buja LM. Myocardial ischemia and reperfusion injury. Cardiovasc Pathol. 2005;14:170–5.
  16. Phrommintikul A, Abdel-Aty H, Schulz-Menger J, et al. Acute oedema in the evaluation of microvascular reperfusion and myocardial salvage in reperfused myocardial infarction with cardiac magnetic resonance imaging. Eur J Radiol. 2010;74:12–7.
  17. O’Regan DP, Ahmed R, Neuwirth C, et al. Cardiac MRI of myocardial salvage at the peri-infarct border zones after primary coronary intervention. Am J Physiol Heart Circ Physiol. 2009;297:340–6.
  18. Englblom E, Hedstrom E, Heiberg E, et al. Rapid initial reduction of hyperenhanced myocardium after reperfused first myocardial infarction suggests recovery of the peri-infarction zone: one-year follow-up by MRI. Circ Cardiovasc Imaging. 2009;2:47–55.
  19. Carlsson M, Ubachs JF, Hedstrom E, et al. Myocardium at risk after acute infarction in humans on cardiac magnetic resonance: quantitative assessment during follow-up and validation with single-photon emission computed tomography. J Am Coll Cardiol Imaging. 2009;2:569–76.
  20. Francone M, Bucciarelli-Ducci C, Carbon I, et al. Impact of primary coronary angioplasty delay on myocardial salvage, infarct size, and microvascular damage in patients with ST-segment elevation myocardial infarction. J Am Coll Cardiol. 2009;54:2145–53.
  21. Hirsch A, Nijveldt R, Haeck JDE, et al. Relation between the assessment of microvascular injury by cardiovascular magnetic resonance and coronary Doppler flow velocity measurements in patients with acute anterior wall myocardial infarction. J Am Coll Cardiol. 2008;51:2230–8.
  22. Appelbaum E, Kirtane AJ, Clark A, et al. Association of TIMI myocardial perfusion grade and ST-segment resolution with cardiovascular magnetic resonance measures of microvascular obstruction and infarct size following ST-segment elevation myocardial infarction. J Thromb Thrombolysis. 2009;27:123–9.
  23. Porto I, Burzotta F, Brancati M, et al. Relationship of myocardial blush grade to microvascular perfusion and myocardial infarct size after primary or rescue percutaneous coronary intervention. Am J Cardiol. 2007;99:1671–3.
  24. Gerber BL, Rochitte CE, Melin JA, et al. Microvascular obstruction and left ventricular remodeling early after acute myocardial infarction. Circulation. 2000;101:2734–41.
  25. Basso C, Thiene G. The pathophysiology of myocardial reperfusion: a pathologist’s perspective. Heart. 2006;92:1559–62.
  26. Basso C, Rizzo S, Thiene G. The metamorphosis of myocardial infarction following coronary recanalization. Cardiovasc Pathol. 2010;19:22–8.
  27. Ewout J, Van Den Bos, Baks T, et al. Magnetic resonance imaging of hemorrhage within reperfused myocardial infarcts: possible interference with iron oxide-labelled cell tracking? Eur Heart J. 2006;27:1620–6.
  28. Choi SH, Kang JW, Kim ST, et al. Investigation of T2-weighted signal intesity of infarcted myocardium and its correlation with delayed enhancement magnetic resonance imaging in a porcine model with reperfused acute myocardial infarction. Int J Cardiovasc Imaging. 2009;1:247–56.
  29. Stork A, Lund GK, Muellerleile K, et al. Characterization of the peri-infarction zone using T2-weighted MRI and delayed-enhancement MRI in patients with acute myocardial infarction. Eur Radiol. 2006;16:2350–7.
  30. Beek AM, Nijveldt R, van Rossum AC. Intramyocardial hemorrhage and microvascular obstruction after primary percutaneous coronary intervention. Int J Cardiovasc Imaging. 2010;26:49–55.
  31. Francone M, Bucciarelli-Ducci C, Carbon I, et al. Impact of primary coronary angioplasty delay on myocardial salvage, infarct size, and microvascular damage in patients with ST-segment elevation myocardial infarction. J Am Coll Cardiol. 2009;54:2145–53.
  32. Tarantini G, Cacciavillani L, Corbetti F, et al. Duration of ischemia is a major determinant of transmurality and severe microvascular obstruction after primary angioplasty. A study performed with contrast-enhanced magnetic resonance. J Am Coll Cardiol. 2005;46:1229–35.
  33. Rehwald W, Fieno DS, Chen EL, et al. Myocardial magnetic resonance imaging contrast agent concentration after reversible and irreversible ischemic injury. Circulation. 2002;105:224–9.
  34. Ingkanisorn WP, Rhoads KL, Aletras AH, et al. Gadolinium delayed enhancement cardiovascular magnetic resonance correlates with clinical measures of myocardial infarction. J Am Coll Cardiol. 2004;43:2253–9.
  35. Baks T, van Geuns RJ, Biagini E, et al. Effects of primary angioplasty for acute myocardial infarction on early and late infarct size and left ventricular wall characteristics. J Am Coll Cardiol. 2006;47:40–4.
  36. Larose E, Rode´s-Cabau J, Pibarot P, et al. Predicting late myocardial recovery and outcomes in the early hours of ST-segment elevation myocardial infarction traditional measures compared with microvascular obstruction, salvaged myocardium, and necrosis characteristics by cardiovascular magnetic resonance. J Am Coll Cardiol. 2010;55:2459–69.
  37. Eitel I, Desch S, Fuernau G, et al. Prognostic significance and determinants of myocardial salvage assessed by cardiovascular magnetic resonance in acute reperfused myocardial infarction. J Am Coll Cardiol. 2010;55:2470–9.
  38. Wu E, Ortiz JT, Tejedor P, et al. Infarct size by contrast enhanced cardiac magnetic resonance is a stronger predictor of outcomes than left ventricular ejection fraction or end-systolic volume index: prospective cohort study. Heart. 2008;94:730–6.
  39. Gerber BL, Garot J, Bluemke DA, et al. Accuracy of contrast-enhanced magnetic resonance imaging in predicting improvement of regional myocardial function in patients after acute myocardial infarction. Circulation. 2002;106:1083–9.
  40. Wagner A, Mahroldt H, Holly TA, et al. Contrast-enhanced MRI and routine single photon emission computed tomography (SPECT) perfusion imaging for detection of subendocardial myocardial infarcts: an imaging study. Lancet. 2003;361:374–9.
  41. Cury RC, Shash K, Nagurney JT, et al. Cardiac magnetic resonance with T2-weighted imaging improves detection of patients with acute coronary syndrome in the emergency department. Circulation. 2008;118:837–44.
  42. Ibrahim T, Bulow HP, Hackl T, et al. Diagnostic value of contrast-enhanced magnetic resonance imaging and single-photon emission computed tomography for detection of myocardial necrosis early after acute myocardial infarction. J Am Coll Cardiol. 2007;49:208–16.





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