Cardiac magnetic resonance demonstrates myocardial oedema in remote tissue early after reperfused myocardial infarction

• Published in: Archives of cardiovascular diseases Vol. 102; no. 8; pp. 633 - 639
• Main Authors: Manrique, Alain, Gerbaud, Edouard, Derumeaux, Geneviève, Cribier, Alain, Bertrand, David, Lebon, Alain, Dacher, Jean-Nicolas
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Masson SAS 01.08.2009; Elsevier; Elsevier/French Society of Cardiology
• Subjects: Adult; Aged; Angioplasty, Balloon, Coronary - instrumentation; Angioplasty, Transluminal, Percutaneous Coronary; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Biological Markers; Biomarkers - blood; Blood and lymphatic vessels; Cardiology and cardiovascular system; Cardiology. Vascular system; Cardiovascular; Case-Control Studies; Coronary heart disease; Edema, Cardiac; Edema, Cardiac - diagnostic imaging; Edema, Cardiac - etiology; Edema, Cardiac - pathology; Female; Fourier Analysis; Heart; Human health and pathology; Humans; Image Interpretation, Computer-Assisted; Infarctus du myocarde; Internal Medicine; IRM; Life Sciences; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; MRI; Myocardial Infarction; Myocardial Infarction - complications; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - pathology; Myocardial Infarction - therapy; Myocarditis. Cardiomyopathies; Myocardium; Myocardium - metabolism; Myocardium - pathology; No-reflow; No-reflow (NR); No-Reflow Phenomenon; No-Reflow Phenomenon - diagnostic imaging; No-Reflow Phenomenon - etiology; No-Reflow Phenomenon - pathology; Oedema; Predictive Value of Tests; Prospective Studies; Radiography; Stents; Thrombolytic Therapy; Time Factors; Treatment Outcome; Troponin; Troponin - blood; Œdème; Myocardial infarction; MRI; IRM; Œdème; NS; Oedema; Infarctus du myocarde; Myocardial longitudinal relaxation time; Myocardial transverse relaxation time; Thrombolysis in myocardial infarction; No-reflow; TE; TIMI; Not significant; Echo time; No-reflow (NR); T1; T2; Heart; Edema; Magnetic resonance; Cardiovascular disease; Coronary heart disease; Myocardial disease; Nuclear magnetic resonance imaging; Tissue; Myocardium; Medical imagery; Early; Cardiology
• ISSN: 1875-2136; 1875-2128
• DOI: 10.1016/j.acvd.2009.05.006

Summary Background Cardiac magnetic resonance can detect myocardial oedema using myocardial transverse relaxation time (T2)-weighted sequences but quantitative data are lacking in patients evaluated early after acute myocardial infarction. Aim To assess the spatial distribution of T2 in patients with recent acute myocardial infarction. Methods Twenty-four consecutive patients (mean age 60 ± 11 years) with acute myocardial infarction (anterior, n = 12; inferior, n = 12) were evaluated prospectively. T2 was determined using a series of breath-hold T2-weighted segmented half-Fourier turbo-spin echo sequences. No-reflow was defined as the association of early hypoenhancement and delayed enhancement in an akinetic region after a bolus injection of DOTA-Gd (0.2 mmol/kg). Results No-reflow was present in 13 (54%) patients and absent in 11 (46%) patients. Mean T2 was increased in the infarct region (84.9 ± 23.7 ms) compared with in the remote myocardium (62.8 ± 10.3 ms, p = 0.0001) and in control subjects (55.7 ± 4.6 ms, p < 0.0001), but also in the remote myocardium compared with control subjects ( p < 0.02). In patients with no-reflow, T2 was further increased within the infarcted subendocardium compared with in patients without no-reflow (97.9 ± 24.8 ms vs 76.3 ± 24.7 ms, p < 0.03). Peak troponin correlated with T2 ( r = 0.47, p < 0.02) and was higher in patients with no-reflow (297.9 ± 249.7 μg/L) than in patients without no-reflow (42.4 ± 43.1 μg/L, p = 0.003). Conclusion T2 was lengthened in both infarcted and remote myocardium and was influenced by the occurrence of no-reflow.