title: Quantification of myocardial area at risk: validation of coronary angiographic scores with cardiovascular magnetic resonance methods.
abstract: OBJECTIVE
  Quantification of myocardial area-at-risk after acute myocardial infarction has major clinical implications and can be determined by cardiovascular magnetic resonance. The Bypass Angioplasty Revascularization Investigation Myocardial Jeopardy Index (BARI) and Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) angiographic scores have been widely used for rapid myocardial area-at-risk estimation but have not been directly validated. Our objective was to compare the myocardial area-at-risk estimated by BARI and APPROACH angiographic scores with those determined by cardiovascular magnetic resonance.
  
  
  METHODS
  In a prospective study, cardiovascular magnetic resonance was performed in 70 patients with a first successfully-reperfused ST-segment elevation acute myocardial infarction in the first week after percutaneous coronary intervention. Myocardial area-at-risk was obtained both by analysis of T2-short tau inversion recovery sequences and calculation of infarct endocardial surface area with late enhancement sequences. These results were compared with those of BARI and APPROACH scores.
  
  
  RESULTS
  BARI and APPROACH showed a statistically significant correlation with T2-short tau inversion recovery for myocardial area-at-risk estimation (BARI, intraclass correlation coefficient=0.72; P<.001; APPROACH, intraclass correlation coefficient=0.69; P<.001). Better correlations were observed for anterior acute myocardial infarction than for other locations (BARI, intraclass correlation coefficient=0.73 vs 0.63; APPROACH, intraclass correlation coefficient=0.68 vs 0.50). Infarct endocardial surface area showed a good correlation with both angiographic scores (BARI, intraclass correlation coefficient=0.72; P<.001; with APPROACH, intraclass correlation coefficient=0.70; P<.001).
  
  
  CONCLUSIONS
  BARI and APPROACH angiographic scores allow reliable estimation of myocardial area-at-risk in current clinical practice, particularly in anterior infarctions. Full English text available from:www.revespcardiol.org.
authors: Servicio de Cardiología, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain. moral.sergio@yahoo.es
authors: Sergio
authors: S
authors: Moral
authors: José F
authors: JF
authors: Rodríguez-Palomares
authors: Martín
authors: M
authors: Descalzo
authors: Gerard
authors: G
authors: Martí
authors: Víctor
authors: V
authors: Pineda
authors: Imanol
authors: I
authors: Otaegui
authors: Bruno
authors: B
authors: García Del Blanco
authors: Artur
authors: A
authors: Evangelista
authors: David
authors: D
authors: García-Dorado
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D001026:Coronary Artery Bypass; D004699:Endocardium / Q000473:pathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology* / Q000601:surgery; D009206:Myocardium / Q000473:pathology*; D015588:Observer Variation; D062645:Percutaneous Coronary Intervention; D015203:Reproducibility of Results; D016896:Treatment Outcome