title: Quantification of regional functional improvement of infarcted myocardium after primary PTCA by contrast-enhanced magnetic resonance imaging.
abstract: OBJECTIVE
  To assess with cardiac magnetic resonance imaging (CMR) the relationship between treatment delay and improvement of regional left ventricular function after primary percutaneous transluminal coronary angioplasty (p-PTCA) for acute myocardial infarction (AMI).
  
  
  METHODS
  We performed cine- and late-enhancement (LE) CMR in 40 patients with first AMI after restoring TIMI 3 flow with p-PTCA and at a follow-up 4 months later. Infarcted segments were determined from LE images. Regional left ventricular function was quantified from cine-CMR images. Segmentation followed the American Heart Association 17-segments model. Patients were divided into groups with delay <3 hours, 3-6 hours, 6-12 hours, and a delay >12 hours.
  
  
  RESULTS
  Segmental wall thickening (SWT) significantly iproved only in segments reperfused within 6 hours (P < 0.001). Follow-up SWT was significantly higher if segments were reperfused early (<3 hours: 74 +/- 4%, 3-6 hours: 57 +/- 4%, 6-12 hours: 48 +/- 7%, <3 to 3-6: P < 0.003, and <3 to 6-12 hours: P < 0.001). The extent of improvement was greater if delay was <3 hours compared to segments with a delay of >3 hours (<3 hours: +21 +/- 3%, 3-6 hours: +8 +/- 4%, 6-12 hours: +6 +/- 3%; <3 hours to 3-6 hours, and 6-12 h, P < 0.02).
  
  
  CONCLUSIONS
  We quantitatively demonstrated that time to p-PTCA treatment significantly influences regional functional recovery of infarcted myocardium at a 4-month follow-up.
authors.affiliation: Clinical Division of Cardiology, Medical University, Innsbruck, Austria.
authors.forename: Gert
authors.initials: G
authors.lastname: Klug
authors.forename: Thomas
authors.initials: T
authors.lastname: Trieb
authors.forename: Michael
authors.initials: M
authors.lastname: Schocke
authors.forename: Michael
authors.initials: M
authors.lastname: Nocker
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Skalla
authors.forename: Agnes
authors.initials: A
authors.lastname: Mayr
authors.forename: Martha
authors.initials: M
authors.lastname: Nowosielski
authors.forename: Kathrin
authors.initials: K
authors.lastname: Pedarnig
authors.forename: Thomas
authors.initials: T
authors.lastname: Bartel
authors.forename: Nico
authors.initials: N
authors.lastname: Moes
authors.forename: Otmar
authors.initials: O
authors.lastname: Pachinger
authors.forename: Bernhard
authors.initials: B
authors.lastname: Metzler
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage; D006801:Humans; D007091:Image Processing, Computer-Assisted; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology* / Q000628:therapy*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA