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European Radiology
Published in: European Radiology 4/2006

01-04-2006 | Experimental

Scarred myocardium imposes additional burden on remote viable myocardium despite a reduction in the extent of area with late contrast MR enhancement

Authors: Maythem Saeed, Randall J. Lee, Oliver Weber, Loi Do, Alastair Martin, Philip Ursell, David Saloner, Charles B. Higgins

Published in: European Radiology | Issue 4/2006

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Abstract

Magnetic resonance imaging (MRI) can simultaneously detect and quantify myocardial dysfunction and shrinkage in contrast-enhanced areas postinfarction. This ability permits the investigation of our hypothesis that transformation of infracted myocardium to scarred tissue imposes additional burdens on peri-infarcted and remote myocardium. Pigs (n=8) were subjected to reperfused infarction. Gd-DOTA-enhanced inversion recovery gradient echo sequence (IR-GRE) imaging was performed 3 days and 8 weeks postinfarction. Global and regional left ventricular (LV) function was evaluated by cine MRI. Triphenyltetrazolium chloride (TTC) stain was used to delineate infarction while hematoxylin and eosin (H & E) and Masson’s trichrome stains were used to characterize remodeled myocardium. Late contrast-enhanced MRIs showed a decrease in the extent of enhanced areas from 17±2% at 3 days to13±1% LV mass at 8 weeks. TTC infarction size was 12±1% LV mass. Cine MRIs showed expansion in dysfunctional area due to unfavorable remodeling, ischemia, or strain. Ejection fraction was reduced in association with increased end-diastolic and end-systolic volumes. Scarred myocardium contained collagen fibers and remodeled thick-walled vessels embedded in collagen. Sequential MRI showed greater LV dysfunction despite the shrinkage in extent of enhanced areas 2 months postinfarction. The integration of late enhancement and cine MRI incorporates anatomical and functional evaluation of remodeled hearts.
Literature
1.
Bolognese L, Cerisano G, Buonamici P, Santini A, Santoro GM, Antoniucci D, Fazzini PF (1997) Influence of infarct-zone viability on left ventricular remodeling after acute myocardial infarction. Circulation 96:3353–3359
2.
Pfeffer MA, Braunwald E (1990) Ventricular remodeling after myocardial infarction. Experimental observations and clinical implications. Circulation 81:1161–1172
3.
Sutton MG, Sharpe N (2000) Left ventricular remodeling after myocardial infarction: pathophysiology and therapy. Circulation 101:2981–2988
4.
McKay RG, Pfeffer MA, Pasternak RC, Markis JE, Come PC, Nakao S, Alderman JD, Ferguson JJ, Safian RD, Grossman W (1986) Left ventricular remodeling after myocardial infarction: a corollary to infarct expansion. Circulation 74:693–702
5.
Dodge HT, Sandler H, Ballew DW, Lord JD Jr (1960) Use of biplane angiocardiography for the measurement of left ventricular volume in man. Am Heart J 60:762–776
6.
Konstam MA, Wynne J, Holman BL, Brown EJ, Neill JM, Kozlowski J (1981) Use of equilibrium (gated) radionuclide ventriculography to quantitate left ventricular output in patients with and without left-sided valvular regurgitation. Circulation 64:578–585
7.
Schiller NB (1991) Two-dimensional echocardiographic determination of left ventricular volume, systolic function and mass. Circulation 84:280–287
8.
Uren NG, Crake T, Lefroy DC, Davies GJ, Maseri A (1994) Reduced coronary vasodilator function in infarcted and normal myocardium after myocardial infarction. N Engl J Med 331:222–227
9.
Gaudron P, Eilles C, Kugler I, Ertl G (1993) Progressive left ventricular dysfunction and remodeling after myocardial infarction: potential mechanisms and early predictions. Circulation 87:755–763
10.
Globits S, De Marco T, Schwitter J, Sakuma H, O’Sullivan M, Rifkin C, Keith F, Chatterjee K, Parmley WW, Higgins CB (1997) Assessment of early left ventricular remodeling in orthotopic heart transplant recipients with cine magnetic resonance imaging: potential mechanisms. J Heart Lung Transplant 16:504–510
11.
Semelka RC, Tomei E, Wagner S, Mayo J, Caputo G, O’Sullivan M, Parmley WW, Chatterjee K, Wolfe C, Higgins CB (1990) Inter-study reproducibility of dimensional and functional measurements between cine magnetic resonance studies in the morphologically abnormal left ventricle. Am Heart J 119:1367–1373
12.
Kuehne T, Saeed M, Gleason K, Turner D, Teitel D, Higgins CB, Moore P (2003) Effects of pulmonary insufficiency on biventricular function in the developing heart of growing swine. Circulation 108:2007–2013
13.
Kramer CM, Rogers WJ, Theobald TM, Power TP, Geskin G, Reichek N (1997) Dissociation between changes in intramyocardial function and left ventricular volumes in eight weeks after first anterior myocardial infarction. J Am Coll Cardiol 30:1625–1632
14.
Kramer CM, Rogers WJ, Theobald TM, Power TP, Petruolo S, Reichek N (1996) Remote noninfarcted region dysfunction soon after anterior myocardial infarction. A magnetic resonance tagging study. Circulation 94:660–666
15.
Kramer CM, Lima JA, Reichek N, Ferrari VA, Llaneras MR, Palmon LC, Yeh IT, Tallant B, Axel L (1993) Regional differences in function within noninfarcted myocardium during left ventricular remodeling. Circulation 88:1279–1288
16.
Hombach V, Grebe O, Merkle N, Waldenmaier S, Hoher M, Kochs M, Wohrle J, Kestler HA (2005) Sequelae of acute myocardial infarction regarding cardiac structure and function and their prognostic significance as assessed by magnetic resonance imaging. Eur Heart J 26:549–557
17.
Ingkanisorn WP, Rhoads KL, Aletras AH, Kellman P, Arai AE (2004) Gadolinium delayed enhancement cardiovascular magnetic resonance correlates with clinical measures of myocardial infarction. J Am Coll Cardiol 43:2253–2259
18.
Choi CJ, Haji-Momenian S, Dimaria JM, Epstein FH, Bove CM, Rogers WJ, Kramer CM (2004) Infarct involution and improved function during healing of acute myocardial infarction: the role of microvascular obstruction. J Cardiovasc Magn Reson 6:915–923
19.
Saeed M, Lee R, Martin A, Weber O, Krombach GA, Schalla S, Lee M, Saloner D, Higgins CB (2004) Transendocardial delivery of extracellular myocardial markers by using combination X-ray/MR fluoroscopic guidance: feasibility study in dogs. Radiology 231:689–696
20.
Bakeman R and Gottman JM (eds) (1986) Observing interaction: an introduction to sequential analysis. Cambridge University Press, Cambridge, UK
21.
Fieno DS, Hillenbrand HB, Rehwald WG, Harris KR, Decker RS, Parker MA, Klocke FJ, Kim RJ, Judd RM (2004) Infarct resorption, compensatory hypertrophy, and differing patterns of ventricular remodeling following myocardial infarction of varying size. J Am Coll Cardiol 43:2124–2131
22.
Korup E, Dalsgaard D, Nyvad O, Jensen TM, Toft E, Berning J (1997) Comparison of degrees of left ventricular dilation within three hours and up to six days after onset of first acute myocardial infarction. Am J Cardiol 80:449–453
23.
Gaudron P, Kugler I, Hu K, Bauer W, Eilles C, Ertal G (2001) Time course of cardiac structural, functional and electrical changes in asymptomatic patients after myocardial infarction: teir interrelation and prognostic impact. J Am Coll Cardiol 38:33–40
24.
Pffere MA (1995) Left ventricular remodeling after acute myocardial infarction. Annu Rev Med 46:455–466
25.
Holmes JW, Yamashita H, Waldman LK, Covell JW (1994) Scar remodeling and transmural deformation after infarction in the pig. Circulation 90:411–420
26.
Kramer CM, Rogers WJ, Park CS, Seibel PS, Shaffer A, Theobald TM, Reichek N, Onodera T, Gerdes AM (1998) Regional myocyte hypertrophy parallels regional myocardial dysfunction during post-infarct remodeling. J Mol Cell Cardiol 30:1773–1778
27.
Bogaert J, Bosmans H, Maes A, Suetens P, Marchal G, Rademakers FE (1994) Remote myocardial dysfunction after acute anterior myocardial infarction: impact of left ventricular shape on regional function: a magnetic resonance myocardial tagging study. J Am Coll Cardiol 35:1525–1534
28.
Inauen W, Payne DK, Kvietys PR, Granger DN (1990) Hypoxia/reoxygenation increases the permeability of endothelial monolayers: role of oxygen radicals. Free Radical Biol Med 9:219–223
29.
Sandstede JJ (2003) Assessment of myocardial viability by MR imaging. Eur Radiol 13:52–61
30.
Mahnken AH, Koos R, Katoh M, Spuentrup E, Busch P, Wildberger JE, Kuhl HP, Gunther RW (2005) Sixteen-slice spiral CT versus MR imaging for assessment of left ventricular function in acute myocardial infarction. Eur Radiol 15:714–720
31.
Gulbins H, Pritisanac A, Anderson I, Uhlig A, Goldemund A, Daebritz S, Meiser B, Reichart B (2003) Myoblasts for survive 16 weeks after intracardiac transfer and start differentiation. Thorac Cardiovasc Surg 51:295–300
32.
Chedrawy EG, Wang JS, Nguyen DM, Shum-Tim D, Chiu RC (2002) Incorporation and integration of implanted myogenic and stem cells into native myocardial fibers: anatomic basis for functional improvements. J Thorac Cardiovasc Surg 124:584–590
33.
Shake JG, Gruber PJ, Baumgartner WA, Senechal G, Meyers J, Redmond JM, Pittenger MF, Martin BJ (2002) Mesenchymal stem cell implantation in a swine myocardial infarct model: engraftment and functional effects. Ann Thorac Surg 73:1919–1925
34.
Jugdutt BI, Menon V, Kumar D, Idikio H (2002) Vascular remodeling during healing after myocardial infarction in dog model. Effect of reperfusion, amlodipine and enalapril. J Am Coll Cardiol 39:1538–1545
35.
Schachinger V, Assmus B, Britten MB, Honold J, Lehmann R, Teupe C, Abolmaali ND, Vogl TJ, Hofmann WK, Martin H, Dimmeler S, Zeiher AM (2004) Transplantation of progenitor cells and regeneration enhancement in acute myocardial infarction. Final one-year results of the TOPCARE-AMI trial. J Am Coll Cardiol 44:1690–1699
Metadata
Title
Scarred myocardium imposes additional burden on remote viable myocardium despite a reduction in the extent of area with late contrast MR enhancement
Authors
Maythem Saeed
Randall J. Lee
Oliver Weber
Loi Do
Alastair Martin
Philip Ursell
David Saloner
Charles B. Higgins
Publication date
01-04-2006
Publisher
Springer-Verlag
Published in
European Radiology / Issue 4/2006
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-005-0052-x

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