Cardiovascular magnetic resonance characterization of peri-infarct zone remodeling following myocardial infarction.
Cardiovascular magnetic resonance characterization of peri-infarct zone remodeling following myocardial infarction.
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DOI：
10.1186/1532-429x-14-24
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发表时间：
2012-04-17
期刊：
影响因子：
--
通讯作者：
Lardo AC
中科院分区：
文献类型：
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作者：
Schuleri KH;Centola M;Evers KS;Zviman A;Evers R;Lima JA;Lardo AC
实施晚期钆增强（LGE）心血管磁共振（CMR）研究的临床研究表明，梗死周围区（PIZ）包含存活和非存活心肌细胞的混合物，并且与室性心动过速诱导和不良心脏结局的易感性增加相关。然而，CMR数据评估的时间形成和功能重塑的特点，这个复杂的区域是有限的。我们打算描述PIZ瘢痕形态和区域功能的早期时间变化。CMR研究在诱导心肌梗死（MI）后90天内的6个时间点进行，8只小型猪再灌注，前间隔梗死。自定义信号密度阈值算法，基于远程心肌，应用于定义梗死核心和PIZ区域的每个时间点。在初始MI后水肿消退后，PIZ从第10天至第90天降低了54%（p = 0.04）。从第3天到第12周，梗死瘢痕的大小扩大了14%，变薄了56%（分别为p = 0.004和p < 0.001）。LVEDV从34.7增加。± 2.2 ml至47.8 ± 3.0 ml（分别为第3天和第12周; p < 0.001）。在MI后30天，梗死瘢痕和PIZ之间的局部周向应变增加（分别为-2.1 ± 0.6和-6.8 ± 0.9;* p < 0.05）。PIZ是动态的，在再灌注MI后质量减少。MI后PIZ中的张力发生变化。PIZ的重塑特征可能为MI后危及生命的心律失常和心源性猝死的发生提供机制性见解。
Clinical studies implementing late gadolinium-enhanced (LGE) cardiovascular magnetic resonance (CMR) studies suggest that the peri-infarct zone (PIZ) contains a mixture of viable and non-viable myocytes, and is associated with greater susceptibility to ventricular tachycardia induction and adverse cardiac outcomes. However, CMR data assessing the temporal formation and functional remodeling characteristics of this complex region are limited. We intended to characterize early temporal changes in scar morphology and regional function in the PIZ. CMR studies were performed at six time points up to 90 days after induction of myocardial infarction (MI) in eight minipigs with reperfused, anterior-septal infarcts. Custom signal density threshold algorithms, based on the remote myocardium, were applied to define the infarct core and PIZ region for each time point. After the initial post-MI edema subsided, the PIZ decreased by 54% from day 10 to day 90 (p = 0.04). The size of infarct scar expanded by 14% and thinned by 56% from day 3 to 12 weeks (p = 0.004 and p < 0.001, respectively). LVEDV increased from 34.7. ± 2.2 ml to 47.8 ± 3.0 ml (day3 and week12, respectively; p < 0.001). At 30 days post-MI, regional circumferential strain was increased between the infarct scar and the PIZ (-2.1 ± 0.6 and -6.8 ± 0.9, respectively;* p < 0.05). The PIZ is dynamic and decreases in mass following reperfused MI. Tensile forces in the PIZ undergo changes following MI. Remodeling characteristics of the PIZ may provide mechanistic insights into the development of life-threatening arrhythmias and sudden cardiac death post-MI.