Cardiac magnetic resonance demonstrates myocardial oedema in remote tissue early after reperfused myocardial infarction.
BACKGROUND
Cardiac magnetic resonance can detect myocardial oedema using myocardial transverse relaxation time (T2)-weighted sequences but quantitative data are lacking in patients evaluated early after acute myocardial infarction.


OBJECTIVE
To assess the spatial distribution of T2 in patients with recent acute myocardial infarction.


METHODS
Twenty-four consecutive patients (mean age 60+/-11 years) with acute myocardial infarction (anterior, n=12; inferior, n=12) were evaluated prospectively. T2 was determined using a series of breath-hold T2-weighted segmented half-Fourier turbo-spin echo sequences. No-reflow was defined as the association of early hypoenhancement and delayed enhancement in an akinetic region after a bolus injection of DOTA-Gd (0.2 mmol/kg).


RESULTS
No-reflow was present in 13 (54%) patients and absent in 11 (46%) patients. Mean T2 was increased in the infarct region (84.9+/-23.7 ms) compared with in the remote myocardium (62.8+/-10.3 ms, p=0.0001) and in control subjects (55.7+/-4.6 ms, p<0.0001), but also in the remote myocardium compared with control subjects (p<0.02). In patients with no-reflow, T2 was further increased within the infarcted subendocardium compared with in patients without no-reflow (97.9+/-24.8 ms vs 76.3+/-24.7 ms, p<0.03). Peak troponin correlated with T2 (r=0.47, p<0.02) and was higher in patients with no-reflow (297.9+/-249.7 microg/L) than in patients without no-reflow (42.4+/-43.1 microg/L, p=0.003).


CONCLUSIONS
T2 was lengthened in both infarcted and remote myocardium and was influenced by the occurrence of no-reflow.
Manrique
Alain
A
Department of Human Investigations, GIP Cyceron, boulevard Henri-Becquerel, BP 5229, 14074 Caen Cedex 05, France. manrique@cyceron.fr
Gerbaud
Edouard
E
Derumeaux
Geneviève
G
Cribier
Alain
A
Bertrand
David
D
Lebon
Alain
A
Dacher
Jean-Nicolas
JN
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D004489:Edema, Cardiac / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D005260:Female; D005583:Fourier Analysis; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D009206:Myocardium / Q000378:metabolism / Q000473:pathology*; D054318:No-Reflow Phenomenon / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011859:Radiography; D015607:Stents; D015912:Thrombolytic Therapy; D013997:Time Factors; D016896:Treatment Outcome; D014336:Troponin / Q000097:blood
D015415:Biomarkers; D014336:Troponin