Gadolinium-DTPA-enhanced magnetic resonance imaging and functional outcome in patients with acute myocardial infarction.
This study was designed to test the hypothesis that Gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA)-enhanced magnetic resonance images (MRI) reflect the severity of ischemic injury during the acute and chronic phases of myocardial infarction (MI). Twenty-nine patients with their first acute MI underwent Gd-DTPA-enhanced MRI in the first week (4.2+/-0.3 days) and at 1 month after onset. Pairs of left ventriculograms were compared with Gd-DTPA-enhanced magnetic resonance images, classified into 3 pattern groups: hyper-enhancement, with and without a central hypo-enhanced region (P1 and P2, respectively), and non-enhancement (P3). In the acute phase of MI, P1 was found in 10, P2 in 11, and P3 in 8 patients. One month later, the image pattern had changed from P1 to P2 in a single patient, from P2 to P3 in 4 patients, and had remained identical in the others. Patients with P3 showed improvement of anterior wall motion in the 1-month follow-up study, and had higher TIMI flow grades and lower peak creatine kinase values than those without recovery. Thus, Gd-DTPA-enhanced magnetic resonance images, closely reflecting the severity of myocardial injury, are useful in predicting myocardial functional recovery after MI.
Fourth Department of Internal Medicine, Shimane Medical University, Izumo, Japan.
J
J
Kitamura
T
T
Shimada
Y
Y
Murakami
K
K
Ochiai
S
S
Inoue
Y
Y
Ishibashi
Y
Y
Kinoshita
K
K
Sano
R
R
Murakami
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003287:Contrast Media; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA; D006439:Hemodynamics; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D013997:Time Factors
D003287:Contrast Media; D019786:Gadolinium DTPA