Cardiac magnetic resonance evaluation of edema after ST-elevation acute myocardial infarction.
OBJECTIVE
The aims of the study were to characterize myocardial edema after ST-elevation acute myocardial infarction using cardiac magnetic resonance imaging and to investigate its impact on ventricular function and its subsequent evolution.


METHODS
In total, 134 patients admitted to hospital for a first ST-elevation myocardial infarction who had a patent infarct-related artery underwent cardiac magnetic resonance imaging. Cine images (at rest and with low-dose dobutamine) and edema, perfusion and viability images were acquired. Imaging was repeated after 6 months.


RESULTS
In the first week after infarction, edema was detected in at least one segment in 96.6% of patients (4+/-2.1 segments per patient). Extensive edema (> or = 4 segments) was associated with large ventricular end-diastolic and end-systolic volumes (P< .0001), a small left ventricular ejection fraction at rest (P=.001) and with low-dose dobutamine (P=.006), a large number of segments showing hypoperfusion (P=.001) or microvascular obstruction (P=.009), a more extensive infarct (P=.017) and greater transmural extent of the infarct (P=.003). The association between the presence and extent of edema during the first week and functional, perfusion and viability variables was still observable after 6 months. No patient exhibited edema at 6 months.


CONCLUSIONS
Cardiac magnetic resonance imaging was useful for characterizing the myocardial edema that occurred after ST-elevation acute myocardial infarction. Extensive edema was associated with poor left ventricular characteristics. Edema was a transitory phenomenon that vanished within 6 months.
Monmeneu
José V
JV
ERESA, Unidad de Imagen Cardiaca, Hospital Clínico Universitario de Valencia, Valencia, Spain. jmonmeneu@eresa.com
Bodí
Vicente
V
Sanchis
Juan
J
López-Lereu
María P
MP
Mainar
Luis
L
Núñez
Julio
J
Chaustre
Fabián
F
Rumiz
Eva
E
Chorro
Francisco J
FJ
Llácer
Angel
A
D004489:Edema, Cardiac / Q000175:diagnosis* / Q000209:etiology*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000503:physiopathology