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Infarct size by cardiovascular magnetic resonance with delay enhancement as prognostic factor in the coronary artery disease: preliminary study
Journal of Cardiovascular Magnetic Resonance volume 11, Article number: P137 (2009)
The magnetic resonance (MR) has taken nowadays a crucial role in the evaluation of ischemic heart disease, which is regarded as the technique of reference for the assessment of myocardial viability. Delay enhanced cardiovascular magnetic resonance (DE-CMR) is a specific marker of myocardial necrosis, using this technique can determine the presence of infarct localization, size and transmurality, parameters of great importance for determining treatment and prognosis.
To determine if infarct size measured by DE-CMR is a prognostic factor for mortality in patients with ischemic heart disease.
Sixty eight patients were referred to cardiovascular magnetic resonance because of suspicion or knowledge of ischemic heart disease between September 2004 and September 2008. CMR imaging was performed using GE 1.5 T system. Steady state free precession (SSFP) cine MR images were acquired in long and short axis orientation. Evaluation of functional parameters including end diastolic volume (EDV), end systolic volume (ESV), left ventricle ejection fraction (LVEF) and systolic volume (SV) indexed a body surface area (BSA).
The average age of the study population was 65.6 (+/- 10.7 SD) years, 12% patients were in functional class III-IV NYHA, the mortality rate was 16.1%. We evaluate 1156 segments and the 39.7% of this presented delay enhancement. The myocardial infarction size was significantly higher in patients who died (21.6% vs. 14.4% p = 0.01). The relationship between infarct size, end-sistolic volume index, end-diastolic volume index, ejection fraction of left ventricle and systolic volume index, were statically significative (p < 0.001). The mayor adverse cardiac events (MACE) were presented in 90% of the group of death patients (p = 0.001). Figure 1.
Infarct size measured by delay enhanced cardiovascular magnetic resonance (DE-CMR) is a prognostic factor for mortality in patients with ischemic heart disease.
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Cainas, L.C., Uvera, S.G.R., Uribe, J.G. et al. Infarct size by cardiovascular magnetic resonance with delay enhancement as prognostic factor in the coronary artery disease: preliminary study. J Cardiovasc Magn Reson 11, P137 (2009). https://doi.org/10.1186/1532-429X-11-S1-P137
- Cardiovascular Magnetic Resonance
- Ischemic Heart Disease
- Infarct Size
- Volume Index
- Steady State Free Precession