title: Short- and long-term changes in myocardial function, morphology, edema, and infarct mass after ST-segment elevation myocardial infarction evaluated by serial magnetic resonance imaging.
abstract: BACKGROUND
  Knowledge of the natural course after an ST-elevation myocardial infarction (STEMI) treated according to guidelines is limited because comprehensive serial magnetic resonance imaging (MRI) of systolic left ventricular function, edema, perfusion, and infarct size after STEMI has not been undertaken. The aim of this study was to evaluate effects of therapy for STEMI on left ventricular function and perfusion and to test the hypothesis that myocardial perfusion by MRI predicts recovery of left ventricular function.
  
  
  METHODS
  Cine MRI, edema, first-pass perfusion, and late enhancement imaging were performed in 58 patients at day 2 and at 1 and 6 months after successful primary percutaneous coronary stent intervention for STEMI.
  
  
  RESULTS
  Ejection fraction increased 6.3% during the first month (P < .001) and 1.9% from 1 to 6 months (P < .06), indicating a maximal recovery very early after the infarction. The systolic wall thickening in the infarct area almost doubled (P < .001), the perfusion of infarcted myocardium increased approximately 50% (P = .02), and perfusion improved in 72% of patients. Edema decreased with a mean of 2 segments (P < .001) during the first month and another 2.5 segments from 1 to 6 months (P < .001). Infarct size decreased to 1 month (P = .01) and was unchanged from 1 to 6 months (P = .5). Baseline perfusion did not predict improvement in ejection fraction (r = 0.2, P = .2) but did predict regional systolic function (P = .03).
  
  
  CONCLUSIONS
  Left ventricular function, perfusion, and infarct mass recovered substantially after STEMI, with the main part of the change within the first month. First-pass perfusion at rest appeared to predict regional ventricular recovery.
authors.affiliation: Department of Cardiology, The Heart Centre, University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Rasmus Sejersten
authors.initials: RS
authors.lastname: Ripa
authors.forename: Jens Christian
authors.initials: JC
authors.lastname: Nilsson
authors.forename: Yongzhong
authors.initials: Y
authors.lastname: Wang
authors.forename: Lars
authors.initials: L
authors.lastname: Søndergaard
authors.forename: Erik
authors.initials: E
authors.lastname: Jørgensen
authors.forename: Jens
authors.initials: J
authors.lastname: Kastrup
mesh_terms: D003326:Coronary Circulation; D004311:Double-Blind Method; D004487:Edema / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D009206:Myocardium / Q000473:pathology*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology*; D013997:Time Factors; D016276:Ventricular Function / Q000502:physiology*