Gadolinium delayed enhancement cardiovascular magnetic resonance correlates with clinical measures of myocardial infarction
Gadolinium delayed enhancement cardiovascular magnetic resonance correlates with clinical measures of myocardial infarction
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DOI：
10.1016/j.jacc.2004.02.046
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发表时间：
2004-06-16
影响因子：
24
通讯作者：
Arai, AE
中科院分区：
文献类型：
--
作者：
Ingkanisorn, WP;Rhoads, KL;Arai, AE
本研究验证了钆延迟增强评估梗死面积与人类心肌梗死（MI）临床指标相关的假设。将心脏磁共振（CMR）测量的急性梗死质量与肌钙蛋白1峰值、急性和慢性左心室（LV）收缩功能进行比较，和近期急性心肌梗死后成像的患者中的慢性梗死块。背景心脏磁共振准确地确定了慢性缺血性心脏病患者的心肌活力，但对于近期心肌梗死尚未得到充分验证。方法首次急性心肌梗死患者（n = 33）或慢性MI（n = 10）行电影CMR后钆延迟增强成像。结果在急性经皮冠状动脉介入治疗的患者中，急性心肌梗死体积与肌钙蛋白I峰值相关（r = 0.83，p <0.001，n = 23）。在20例急性心肌梗死患者的随访CMR扫描中，急性心肌梗死面积与随访左室射血分数具有良好的相关性（r = 0.86，p <0.001）。延迟增强的透壁范围与急性（p <0.001）和随访（p <0.001）时测得的室壁增厚呈显著负相关。虽然慢性梗死面积是可重复的，（11 +/-4%对比12 +/-7%，p = NS），急性梗死面积从16 +/-12%降至11 +/-9%结论在急性心肌梗死后不久成像的人中，钆延迟增强急性CMR梗死面积与梗死面积的急性和慢性指数相关，但在随访中似乎会缩小。(C)2004年，美国心脏病学会基金会。
OBJECTIVES The current study tested the hypothesis that gadolinium delayed enhancement assessment of infarct size correlates with clinical indices of myocardial infarction (MI) in humans. Acute infarct mass by cardiac magnetic resonance (CMR) was compared with peak troponin 1, acute and chronic left ventricular (LV) systolic function, and chronic infarct mass in patients imaged after recent acute MI.BACKGROUND Cardiac magnetic resonance accurately determines myocardial viability in patients with chronic ischemic heart disease but is not well validated for recent MI.METHODS Patients with first acute MI (n = 33) or chronic MI (n = 10) underwent cine CMR followed by gadolinium delayed enhancement imaging. A follow-up CMR scan was performed on 20 of the 33 acute MI patients and all of the chronic MI patients.RESULTS In patients with acute percutaneous coronary intervention, acute MI mass correlated with peak troponin I (r = 0.83, p < 0.001, n = 23). In the 20 acute infarct patients with follow-up CMR scans, the acute infarct size correlated well with the follow-up LV ejection fraction (r = 0.86, p < 0.001). The transmural extent of delayed enhancement imaged acutely correlated inversely with wall thickening measured acutely (p < 0.001) and at follow-up (p < 0.001). Although chronic infarct size was reproducible (11 +/- 4% vs. 12 +/- 7%, p = NS), acute infarct size decreased from 16 +/- 12% to 11 +/- 9% (p < 0.003).CONCLUSION In humans imaged shortly after acute MI, gadolinium delayed enhancement acute CMR infarct size correlates with acute and chronic indices of infarct size but will appear to diminish in size on follow-up. (C) 2004 by the American College of Cardiology Foundation.