Comparison of wall thickening and ejection fraction by cardiovascular magnetic resonance and echocardiography in acute myocardial infarction.
OBJECTIVE
The purpose of this study was to compare cardiovascular magnetic resonance (CMR) and echocardiography (echo) in patients treated with primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) with emphasis on the analysis of left ventricular function and left ventricular wall motion characteristics.


METHODS
We performed CMR and echo in 52 patients with first AMI shortly after primary angioplasty and four months thereafter. CMR included cine-MR and T1-weighted first-pass and late-gadolinium enhancement (LGE) sequences. Global ejection fraction (EF(CMR), %) and regional left ventricular function (systolic wall thickening %, [SWT]) were determined from cine-MR images. In echo the global left ventricular function (EF(echo), %) and regional wall motion abnormalities were determined. A segment in echo was scored as "infarcted" if it was visually > 50% hypokinetic.


RESULTS
EF(echo) revealed a poor significant agreement with EF(CMR) at baseline (r: 0.326; p < 0.01) but higher correlation at follow-up (r: 0.479; p < 0.001). The number of infarcted segments in echocardiography correlated best with the number of segments which showed systolic wall thickening < 30% (r: 0.498; p < 0.001) at baseline and (r: 0.474; p < 0.001) at follow-up. Improvement of EF was detected in both CMR and echocardiography increasing from 44.2 +/- 11.6% to 49.2 +/- 11% (p < 0.001) by CMR and from 51.2 +/- 8.1% to 54.5 +/- 8.3% (p < 0.001) by echocardiography.


CONCLUSIONS
Wall motion and EF by CMR and echocardiography correlate poorly in the acute stage of myocardial infarction. Correlation improves after four months. Systolic wall thickening by CMR < 30% indicates an infarcted segment with influence on the left ventricular function.
Nowosielski
Martha
M
Clinical Division of Cardiology, Innsbruck Medical University, Innsbruck, Austria. Martha.Nowosielski@student.i-med.ac.at
Schocke
Michael
M
Mayr
Agnes
A
Pedarnig
Kathrin
K
Klug
Gert
G
Köhler
Almut
A
Bartel
Thomas
T
Müller
Silvana
S
Trieb
Thomas
T
Pachinger
Otmar
O
Metzler
Bernhard
B
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003287:Contrast Media; D004452:Echocardiography; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D009206:Myocardium / Q000473:pathology*; D011237:Predictive Value of Tests; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
D003287:Contrast Media; D019786:Gadolinium DTPA