[Reliability of cardiac magnetic resonance imaging indicators of myocardial viability for predicting the recovery of systolic function after a first acute myocardial infarction with a patent culprit artery].
OBJECTIVE
To assess the reliability of early analysis of the most frequently used cardiac magnetic resonance (CMR)-derived indexes for predicting systolic function recovery and ventricular remodeling in patients after a first acute myocardial infarction with a patent culprit artery.


METHODS
17 patients were studied with an initial CMR protocol that included regional assessment of wall thickness and wall thickening, low-dose dobutamine response, first-pass gadolinium myocardial perfusion imaging and delayed enhancement. These results were compared with those obtained for segmental and global function in a second CMR study 6 months later.


RESULTS
Of the 272 myocardial segments evaluated in the initial study, 73 showed severe systolic dysfunction. The findings were used to calculate sensitivity and specificity of each of the indexes mentioned above for predicting myocardial viability. The sensitivities and specificities for each index were wall thickness > or =5.5 mm, 100% and 12%; low-dose dobutamine response, 41% and 93%; normal myocardial perfusion, 78% and 68%; delayed enhancement, 81% and 95%. Multivariate analysis showed that delayed enhancement was the only independent predictor of contractility (r=-0.83, P=.0001), ventricular volumes (end-diastolic: r=0.61, P=.009, end-systolic: r=0.67, P=.003) and ejection fraction (r=-0.73, P=.001) at 6 months.


CONCLUSIONS
Delayed enhancement seen in CMR is a reliable, quantifiable index for predicting recovery of systolic function and ventricular remodeling in patients after a first infarction with a patent culprit artery.
López Lereu
María P
MP
Unidad de Resonancia Magnética (ERESA), Hospital Clínico Universitario, Valencia, Spain. plereu@eresa.com
Bodí
Vicente
V
Sanchis
Juan
J
García
Diego
D
Pellicer
Mauricio
M
Losada
Antonio
A
Chorro
Francisco J
FJ
Estornell
Jordi
J
Igual
Begoña
B
Maceira
Alicia
A
Martín
Joaquín
J
Llàcer
Angel
A
D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000628:therapy*; D009204:Myocardial Revascularization / Q000379:methods; D009206:Myocardium / Q000473:pathology; D011859:Radiography; D015203:Reproducibility of Results; D013599:Systole; D016277:Ventricular Function, Left / Q000502:physiology
Fiabilidad de los índices de viabilidad miocárdica por resonancia magnética para predecir la mejoría de la función sistólica en pacientes con un primer infarto reciente y arteria abierta.