Infarct transmurality and adjacent segmental function as determinants of wall thickening in revascularized chronic ischemic heart disease.
BACKGROUND
There are many factors which influence regional left ventricular wall thickening (WT) in ischemic heart disease (IHD). We used magnetic resonance imaging (MRI) to explore, in patients with chronic ischemic heart disease (CIHD), how regional WT is affected by both infarct transmurality (IT) and the function of adjacent segments. We also compared these findings with a group of healthy volunteers (controls).


METHODS
Twenty patients (20 men, mean age 63, range 45-80 years) were imaged with cine MRI for function and delayed enhancement MRI for infarction 6 months after revascularization. Twenty age and sex matched controls underwent cine MRI. Short-axis images were analysed using a 12-segment per slice model in four midventricular slices per subject.


RESULTS
WT and IT were inversely related (r(2) = 0.11, P<0.001). WT of non-infarcted segments in patients was lower than corresponding segments in controls (5.1 versus 4.6 mm, P<0.001). WT in patients decreased with an increasing number of dysfunctional adjacent segments (P<0.001) and increasing IT (P<0.001). WT was more strongly influenced by the number of dysfunctional adjacent segments (t = -22.93, P<0.001) than by IT (t = -4.50, P<0.001).


CONCLUSIONS
The number of dysfunctional adjacent segments is a greater determinant than infarct transmurality on regional wall thickening.
Department of Clinical Physiology, Lund University Hospital, Lund, Sweden.
Martin
M
Ugander
Peter A
PA
Cain
Annick
A
Perron
Erik
E
Hedström
Håkan
H
Arheden
D000368:Aged; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D009204:Myocardial Revascularization; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control*