Myocardial tissue characterisation and functional assessment by magnetic resonance imaging in ST elevation myocardial infarction

摘要: Objectives:- To evaluate myocardial tissue characterisation by cardiovascular magnetic resonance (CMR) to predict functional recovery in reperfused acute infarction (AMI). Background:- Prognosis following AMI is closely related of contractile function. Accurate early prediction may allow for additional therapies high risk patients, and avoid over-treatment lower patients. Clinical prognostication commonly relies on echocardiographic evaluation function, which be misleading acutely. CMR offers a number ways refine characterising tissue, but these have not been extensively evaluated. Methods:- Patients reperfusion first-presentation ST-elevation were scanned acutely, subacutely convalescence. Tissue pathologies visible evaluated their ability Oedema the peri-infarct zone, microvascular obstruction (MO) intramyocardial haemorrhage (IMH) infarct extracellular volume (ECV) zone evaluated. In addition, susceptibility-weighted MR imaging (SW-MRI) was against reference standards T2-weighted T2* detect known prognostic marker IMH. Results:- Acutely oedematous myocardium demonstrated function over time (p 0.05). Recovery mirrored resolution oedema. Infarct attenuated infarcts that MO acutely as compared those without (p<0.01), further IMH (p<0.01). SW-MRI had sensitivity 93% specificity 86% imaging, with excellent inter-observer reliability shorter breath-hold times (4 seconds vs. 16 seconds). ECV higher accuracy improved wall motion than late gadolinium enhancement (c-statistic 0.80 0.70, p=0.04). Conclusion:- Tissue variety outcome AMI, using both established novel techniques.