Accuracy of Area at Risk Quantification by Cardiac Magnetic Resonance According to the Myocardial Infarction Territory

Translated title of the contribution: Accuracy of Area at Risk Quantification by Cardiac Magnetic Resonance According to the Myocardial Infarction Territory

Leticia Fernández-Friera, José Manuel García-Ruiz, Ana García-Álvarez, Rodrigo Fernández-Jiménez, Javier Sánchez-González, Xavier Rossello, Sandra Gómez-Talavera, Gonzalo J. López-Martín, Gonzalo Pizarro, Valentín Fuster, Borja Ibáñez

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Introduction and objectives Area at risk (AAR) quantification is important to evaluate the efficacy of cardioprotective therapies. However, postinfarction AAR assessment could be influenced by the infarcted coronary territory. Our aim was to determine the accuracy of T2-weighted short tau triple-inversion recovery (T2W-STIR) cardiac magnetic resonance (CMR) imaging for accurate AAR quantification in anterior, lateral, and inferior myocardial infarctions. Methods Acute reperfused myocardial infarction was experimentally induced in 12 pigs, with 40-minute occlusion of the left anterior descending (n = 4), left circumflex (n = 4), and right coronary arteries (n = 4). Perfusion CMR was performed during selective intracoronary gadolinium injection at the coronary occlusion site (in vivo criterion standard) and, additionally, a 7-day CMR, including T2W-STIR sequences, was performed. Finally, all animals were sacrificed and underwent postmortem Evans blue staining (classic criterion standard). Results The concordance between the CMR-based criterion standard and T2W-STIR to quantify AAR was high for anterior and inferior infarctions (r = 0.73; P =.001; mean error = 0.50%; limits = −12.68%-13.68% and r = 0.87; P =.001; mean error = −1.5%; limits = −8.0%-5.8%, respectively). Conversely, the correlation for the circumflex territories was poor (r = 0.21, P =.37), showing a higher mean error and wider limits of agreement. A strong correlation between pathology and the CMR-based criterion standard was observed (r = 0.84, P <.001; mean error = 0.91%; limits = −7.55%-9.37%). Conclusions T2W-STIR CMR sequences are accurate to determine the AAR for anterior and inferior infarctions; however, their accuracy for lateral infarctions is poor. These findings may have important implications for the design and interpretation of clinical trials evaluating the effectiveness of cardioprotective therapies. Full English text available from: www.revespcardiol.org/en

Translated title of the contributionAccuracy of Area at Risk Quantification by Cardiac Magnetic Resonance According to the Myocardial Infarction Territory
Original languageEnglish
Pages (from-to)323-330
Number of pages8
JournalRevista Espanola de Cardiologia
Volume70
Issue number5
DOIs
StatePublished - May 2017

Keywords

  • Imaging
  • Magnetic resonance imaging
  • Myocardial infarction
  • Myocardial ischemia

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