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Journal of Cardiovascular Magnetic Resonance

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Open Access 01-12-2012 | Research

Assessment of distribution and evolution of Mechanical dyssynchrony in a porcine model of myocardial infarction by cardiovascular magnetic resonance

Authors: Khaled Z Abd-Elmoniem, Miguel Santaularia Tomas, Tetsuo Sasano, Sahar Soleimanifard, Evert-Jan P Vonken, Amr Youssef, Harsh Agarwal, Veronica L Dimaano, Hugh Calkins, Matthias Stuber, Jerry L Prince, Theodore P Abraham, M Roselle Abraham

Published in: Journal of Cardiovascular Magnetic Resonance | Issue 1/2012

Abstract

Background

We sought to investigate the relationship between infarct and dyssynchrony post- myocardial infarct (MI), in a porcine model. Mechanical dyssynchrony post-MI is associated with left ventricular (LV) remodeling and increased mortality.

Methods

Cine, gadolinium-contrast, and tagged cardiovascular magnetic resonance (CMR) were performed pre-MI, 9 ± 2 days (early post-MI), and 33 ± 10 days (late post-MI) post-MI in 6 pigs to characterize cardiac morphology, location and extent of MI, and regional mechanics. LV mechanics were assessed by circumferential strain (eC). Electro-anatomic mapping (EAM) was performed within 24 hrs of CMR and prior to sacrifice.

Results

Mean infarct size was 21 ± 4% of LV volume with evidence of post-MI remodeling. Global eC significantly decreased post MI (-27 ± 1.6% vs. -18 ± 2.5% (early) and -17 ± 2.7% (late), p < 0.0001) with no significant change in peri-MI and MI segments between early and late time-points. Time to peak strain (TTP) was significantly longer in MI, compared to normal and peri-MI segments, both early (440 ± 40 ms vs. 329 ± 40 ms and 332 ± 36 ms, respectively; p = 0.0002) and late post-MI (442 ± 63 ms vs. 321 ± 40 ms and 355 ± 61 ms, respectively; p = 0.012). The standard deviation of TTP in 16 segments (SD16) significantly increased post-MI: 28 ± 7 ms to 50 ± 10 ms (early, p = 0.012) to 54 ± 19 ms (late, p = 0.004), with no change between early and late post-MI time-points (p = 0.56). TTP was not related to reduction of segmental contractility. EAM revealed late electrical activation and greatly diminished conduction velocity in the infarct (5.7 ± 2.4 cm/s), when compared to peri-infarct (18.7 ± 10.3 cm/s) and remote myocardium (39 ± 20.5 cm/s).

Conclusions

Mechanical dyssynchrony occurs early after MI and is the result of delayed electrical and mechanical activation in the infarct.

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Title: Assessment of distribution and evolution of Mechanical dyssynchrony in a porcine model of myocardial infarction by cardiovascular magnetic resonance
Authors: Khaled Z Abd-Elmoniem
Miguel Santaularia Tomas
Tetsuo Sasano
Sahar Soleimanifard
Evert-Jan P Vonken
Amr Youssef
Harsh Agarwal
Veronica L Dimaano
Hugh Calkins
Matthias Stuber
Jerry L Prince
Theodore P Abraham
M Roselle Abraham
Publication date: 01-12-2012
Publisher: BioMed Central
Published in: Journal of Cardiovascular Magnetic Resonance / Issue 1/2012
Electronic ISSN: 1532-429X
DOI: https://doi.org/10.1186/1532-429X-14-1

At a glance: The STEP trials

Springer Medicine

Assessment of distribution and evolution of Mechanical dyssynchrony in a porcine model of myocardial infarction by cardiovascular magnetic resonance

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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