Cardiac and extracardiac abnormalities detected by cardiac magnetic resonance in a post-myocardial infarction cohort.
OBJECTIVE
All patients should undergo formal assessment of ventricular function following acute myocardial infarction (AMI). Cardiac magnetic resonance (CMR) is not widely used as a test before discharge in AMI patients. This study sought to determine the impact of contrast-enhanced CMR (ceCMR) scanning before discharge in addition to standard transthoracic echocardiography (TTE) on patient care following AMI.


METHODS
100 patients admitted with AMI, all of whom had a left ventricular ejection fraction (LVEF) <40% on TTE, underwent ceCMR imaging before discharge. Abnormalities of clinical relevance detected on ceCMR, which influenced patient management, are reported.


RESULTS
Each patient (77% male, mean age 58.9 years, SD 12) underwent TTE and ceCMR at a mean 1.4 (range 0.8-3.2) and 4.2 days (range 2-11), respectively, following admission. ceCMR significantly influenced the management of 24/100 (24%) of the patient cohort, through detection of LV thrombus, right ventricular infarction, intracardiac neoplasia, and a variety of intrathoracic and intra-abdominal pathology. There were no issues regarding safety in this high-risk group of patients.


CONCLUSIONS
In a cohort of AMI patients with reduced LVEF, ceCMR scanning before discharge improved the management of 24% of the cohort. ceCMR is a useful and safe adjunct to standard care after AMI.
Weir
Robin A P
RA
Cardiology Department, Western Infirmary, Glasgow, UK. robinweir75@hotmail.com
Martin
Thomas N
TN
Petrie
Colin J
CJ
Murphy
Aengus
A
Clements
Suzanne
S
Steedman
Tracey
T
Wagner
Galen S
GS
McMurray
John J V
JJ
Dargie
Henry J
HJ
D000368:Aged; D015331:Cohort Studies; D004452:Echocardiography; D005260:Female; D006325:Heart Atria; D006338:Heart Neoplasms / Q000175:diagnosis; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology*; D009206:Myocardium / Q000473:pathology*; D009232:Myxoma / Q000175:diagnosis; D016032:Randomized Controlled Trials as Topic; D013927:Thrombosis / Q000175:diagnosis; D018487:Ventricular Dysfunction, Left / Q000473:pathology*