title: Remodeling of the infarct territory in the time course of infarct healing in humans.
abstract: OBJECTIVE
  To analyze the remodeling processes of the infarct territory in the time course of infarct healing.
  
  
  METHODS
  Serial late enhancement (LE) studies were performed in 30 patients following reperfused myocardial infarction (MI) in the first and second week post-MI and after 3 months. To characterize infarct remodeling over time, the following variables were derived and analyzed in a blinded fashion: Infarct size (IS, in mm(3)), maximum infarct thickness (IT(max), mm), mean infarct thickness (IT(mean), mm) and the variability of infarct thickness (VIT=IT(max)/IT(mean)). Further, a new parameter for the assessment of infarct remodeling, the infarct extent (IE, mm(2)) was computed. IE quantifies IS in two dimensions along the heart's circumferential and longitudinal directions. IS was divided by the IE to obtain IT(mean).
  
  
  RESULTS
  Overall infarct thickness was highly variable. Infarct shrinkage due to infarct thinning and IE reduction was found in the first months of healing. IS, IT(mean) and IT(max) significantly decreased during follow-up. There was a less consistent change of the IE: IE decreased in 75% of all infarcts from the first week up to 3 months post-MI, whereas 25% of infarcts expanded. Infarct thinning was found in almost all patients (92%), hence occurring in patients with infarct expansion and in patients without infarct expansion.
  
  
  CONCLUSIONS
  Infarct thinning and-to a lesser extent-IE reduction, contribute to infarct shrinkage in the time course of infarct healing. Infarct thinning may occur without infarct expansion.
authors.affiliation: Department of Internal Medicine I, Center of Cardiovascular Medicine, University Hospital Würzburg, Oberdürrbacher-Str. 6, 97080, Würzburg, Germany. hillenbran_h@medizin.uni-wuerzburg.de
authors.forename: Hanns B
authors.initials: HB
authors.lastname: Hillenbrand
authors.forename: Joern
authors.initials: J
authors.lastname: Sandstede
authors.forename: Stefan
authors.initials: S
authors.lastname: Störk
authors.forename: Benjamin
authors.initials: B
authors.lastname: Ramsayer
authors.forename: Dietbert
authors.initials: D
authors.lastname: Hahn
authors.forename: Georg
authors.initials: G
authors.lastname: Ertl
authors.forename: Herbert
authors.initials: H
authors.lastname: Koestler
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Bauer
authors.forename: Christian
authors.initials: C
authors.lastname: Ritter
mesh_terms: D000328:Adult; D000368:Aged; D024803:Biomedical Enhancement / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology* / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000379:methods*; D020257:Ventricular Remodeling; D014945:Wound Healing