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Published in: European Radiology 2/2019

01-02-2019 | Cardiac

BOLD cardiac MRI for differentiating reversible and irreversible myocardial damage in ST segment elevation myocardial infarction

Authors: Bing-Hua Chen, Ruo-Yang Shi, Dong-Aolei An, Rui Wu, Chong-Wen Wu, Jiani Hu, Amanda Manly, Hisham Kaddurah, Jie He, Jun Pu, Jian-Rong Xu, Lian-Ming Wu

Published in: European Radiology | Issue 2/2019

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Abstract

Objectives

BOLD imaging is a quantitative MRI technique allowing the evaluation of the balance between supply/demand in myocardial oxygenation and myocardial haemorrhage. We sought to investigate the ability of BOLD imaging to differentiate reversible from irreversible myocardial injury as well as the chronological progression of myocardial oxygenation after reperfusion in patients with ST segment elevation myocardial infarction (STEMI).

Methods

Twenty-two patients (age, 60 ± 11 years; 77.3% male) with STEMI underwent cardiac MRIs on four occasions: on days 1, 3, 7 and 30 after reperfusion. BOLD MRI was obtained with a multi-echo turbo field echo (TFE) sequence on a 3-T scanner to assess myocardial oxygenation in MI.

Results

T2* value in MI with intramyocardial haemorrhage (IMH) was the lowest (9.77 ± 3.29 ms), while that of the salvaged zone was the highest (33.97 ± 3.42 ms). T2* values in salvaged myocardium demonstrated a unimodal temporal pattern from days 1 (37.91 ± 2.23 ms) to 30 (30.68 ± 1.59 ms). T2* values in the MI regions were significantly lower than those in remote myocardium, although the trends in both were constant overall. There was a slightly positive correlation between T2* in MI regions and EF (Rho = 0.27, p < 0.05) or SV (Rho = 0.22, p = 0.04) and a slightly negative correlation between T2* in salvaged myocardium and LVEDV (Rho = – 0.23, p < 0.05).

Conclusions

BOLD MRI performed in post-STEMI patients allows accurate evaluation of myocardial damage severity and could differentiate reversible from irreversible myocardial injury. The increased T2* values may imply the pathophysiological mechanism of salvaged myocardium. BOLD MRI could represent a more accurate alternative to the other currently available options.

Key Points

• Myocardial oxygenation and haemorrhage after myocardial infarction affect BOLD MRI values
• BOLD MRI could be used to differentiate irreversible from reversible myocardial damage
• Changed oxygenation implies the pathophysiological mechanism of salvaged myocardium
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Metadata
Title
BOLD cardiac MRI for differentiating reversible and irreversible myocardial damage in ST segment elevation myocardial infarction
Authors
Bing-Hua Chen
Ruo-Yang Shi
Dong-Aolei An
Rui Wu
Chong-Wen Wu
Jiani Hu
Amanda Manly
Hisham Kaddurah
Jie He
Jun Pu
Jian-Rong Xu
Lian-Ming Wu
Publication date
01-02-2019
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5612-y

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