Diagnostic value of routine clinical parameters in acute myocardial infarction: a comparison to delayed contrast enhanced magnetic resonance imaging. Delayed enhancement and routine clinical parameters after myocardial infarction.
OBJECTIVE
Contrast enhanced magnetic resonance imaging (ceMRI) has been shown to reliably identify irreversible myocardial injury. The aim of this study was to compare the findings on ceMRI with routine clinical markers of myocardial injury in patients with acute myocardial infarction (MI).


RESULTS
Twenty-four patients with acute MI were investigated at 1.5 T. The global myocardial function was analysed with a standard cine MR protocol and a stack of short axis slices encompassing the entire left ventricle. Corresponding short axis slices were acquired for delayed ceMRI 15-20 min after the administration of 0.2 mmol gadolinium-DTPA/kg body weight. Mass of hyperenhancement and peak creatine kinase release (peak CK) was determined for each patient. The presenting 12-lead ECG was analysed for ST-elevation on admission and later development of Q-waves. Mass of hyperenhancement correlated moderately well to peak CK (r = 0.65, p < 0.01) and endsystolic volume index (r = 0.55, p < 0.01). Mass of hyperenhancement was inversely correlated to ejection fraction (r = -0.50, p = 0.02). Neither the presence of ST elevation on the admission ECG nor the later development of Q-waves did relate to the transmural extent of hyperenhancement and to the mass of hyperenhancement.


CONCLUSIONS
Mass of hyperenhancement significantly correlates to global myocardial function and to peak CK. However, there is no relationship between the findings in ceMRI and 12-lead ECG abnormalities on admission suggesting an advantage of ceMRI in defining transmural extent and depicting small areas of necrosis.
Petersen
Steffen E
SE
2nd Medical Clinic, University Hospital Mainz, Germany. steffen.petersen@gmx.de
Horstick
Georg
G
Voigtländer
Thomas
T
Kreitner
Karl-Friedrich
KF
Wittlinger
Thomas
T
Ziegler
Steffen
S
Abegunewardene
Nico
N
Schmitt
Melanie
M
Schreiber
Wolfgang G
WG
Kalden
Peter
P
Mohrs
Oliver K
OK
Thelen
Manfred
M
Meyer
Juergen
J
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D003287:Contrast Media; D017023:Coronary Angiography; D003402:Creatine Kinase / Q000097:blood; D003955:Diagnostic Tests, Routine; D004562:Electrocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D011856:Radiographic Image Enhancement; D013223:Statistics as Topic; D013318:Stroke Volume / Q000502:physiology; D013997:Time Factors
D015415:Biomarkers; D003287:Contrast Media; D003402:Creatine Kinase