title: New perspectives on the role of cardiac magnetic resonance imaging to evaluate myocardial salvage and myocardial hemorrhage after acute reperfused ST-elevation myocardial infarction.
abstract: Cardiac magnetic resonance (CMR) imaging enables the assessment of left ventricular function and pathology. In addition to established contrast-enhanced methods for the assessment of infarct size and microvascular obstruction, other infarct pathologies, such as myocardial edema and myocardial hemorrhage, can be identified using innovative CMR techniques. The initial extent of myocardial edema revealed by T2-weighted CMR has to be stable for edema to be taken as a retrospective marker of the area-at-risk, which is used to calculate myocardial salvage. The timing of edema assessment is important and should be focused within 2 - 7 days post-reperfusion. Some recent investigations have called into question the diagnostic validity of edema imaging after acute STEMI. Considering the results of these studies, as well as results from our own laboratory, we conclude that the time-course of edema post-STEMI is unimodal, not bimodal. Myocardial hemorrhage is the final consequence of severe vascular injury and a progressive and prognostically important complication early post-MI. Myocardial hemorrhage is a therapeutic target to limit reperfusion injury and infarct size post-STEMI.
authors.affiliation: a BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences , University of Glasgow , Glasgow , UK.|b West of Scotland Regional Heart & Lung Centre , Golden Jubilee National Hospital , Clydebank , UK.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Mangion
authors.affiliation: a BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences , University of Glasgow , Glasgow , UK.|b West of Scotland Regional Heart & Lung Centre , Golden Jubilee National Hospital , Clydebank , UK.
authors.forename: David
authors.initials: D
authors.lastname: Corcoran
authors.affiliation: a BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences , University of Glasgow , Glasgow , UK.|b West of Scotland Regional Heart & Lung Centre , Golden Jubilee National Hospital , Clydebank , UK.
authors.forename: David
authors.initials: D
authors.lastname: Carrick
authors.affiliation: a BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences , University of Glasgow , Glasgow , UK.|b West of Scotland Regional Heart & Lung Centre , Golden Jubilee National Hospital , Clydebank , UK.
authors.forename: Colin
authors.initials: C
authors.lastname: Berry
mesh_terms: D015415:Biomarkers; D004487:Edema / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D015425:Myocardial Reperfusion; D009206:Myocardium / Q000473:pathology*; D011379:Prognosis; D000072657:ST Elevation Myocardial Infarction / Q000000981:diagnostic imaging*; D013997:Time Factors; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers
keywords: ST-elevation myocardial infarction; magnetic resonance imaging; microvascular dysfunction; myocardial hemorrhage; prognosis; remodeling