title: Assessment of circumferential endocardial extent of myocardial edema and infarction in patients with reperfused acute myocardial infarction: a cardiovascular magnetic resonance study.
abstract: T2 weighted (T2W) images on cardiovascular magnetic resonance (CMR) visualizes myocardial edema, which reflects the myocardial area at risk (AAR) in reperfused acute myocardial infarction (AMI). Late gadolinium enhancement (LGE) demonstrates myocardial infarction. LGE images cover the whole left ventricle, but T2W images are obtained from a few slices of the left ventricle due to the long sequence time, so the quantification of AAR of the entire left ventricle is difficult. We hypothesize that we can quantify AAR with only LGE images if there is a strong correlation between the circumferential endocardial extent of myocardial edema and infarction. Thirty patients with first AMI were enrolled. All patients underwent successfully reperfusion therapy and CMR was performed within the first week after the event. We measured the circumferential extent of edema and infarction on short-axis views (T2 angle and LGE angle), respectively. A total of 82 short-axis slices showed transmural edema on T2W images. Corresponding LGE images were analyzed for the circumferential extent of infarction. The median [interquartile range] of T2 angle and DE angle were 147° [116°-219°] and 134° [104°-200°] in patients with LAD culprit lesion, 91° [87°-101°] and 85° [80°-90°] in LCX, and 110° [94°-123°] and 104° [89°-118°] in RCA, respectively. T2 angle was well correlated with LGE angle (r = 0.99, P < 0.01). There is a strong correlation between the circumferential extent of edema and infarction in reperfused AMI. Thus, T2 weighted imaging can be skipped to quantify the amount of AAR.
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University.
authors.forename: Shingo
authors.initials: S
authors.lastname: Ota
authors.forename: Takashi
authors.initials: T
authors.lastname: Tanimoto
authors.forename: Kumiko
authors.initials: K
authors.lastname: Hirata
authors.forename: Makoto
authors.initials: M
authors.lastname: Orii
authors.forename: Yasutsugu
authors.initials: Y
authors.lastname: Shiono
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Shimamura
authors.forename: Kohei
authors.initials: K
authors.lastname: Ishibashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamano
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ino
authors.forename: Hironori
authors.initials: H
authors.lastname: Kitabata
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Takashi
authors.initials: T
authors.lastname: Kubo
authors.forename: Toshio
authors.initials: T
authors.lastname: Imanishi
authors.forename: Takashi
authors.initials: T
authors.lastname: Akasaka
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D004487:Edema / Q000175:diagnosis* / Q000209:etiology; D004699:Endocardium / Q000473:pathology*; D005260:Female; D006801:Humans; D007089:Image Enhancement; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D009203:Myocardial Infarction / Q000150:complications* / Q000175:diagnosis; D009206:Myocardium / Q000473:pathology*; D015203:Reproducibility of Results