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Relationship between infarct transmurality and regional myocardial function at different levels of the left ventricle in patients with first-time ST-elevation myocardial infarction
© Hala et al; licensee BioMed Central Ltd. 2010
Published: 21 January 2010
The relationship between regional myocardial function and the transmural extent of infarction (TEI) is complex, and there is considerable overlap in wall thickening measurements between normal and infarcted segments. Some of this overlap is caused by tethering from neighbor segments, but could possibly also be caused by errors in wall thickening measurements due to: 1)through-plane motion in basal segments, and 2)oblique orientation of the image plane relative to the left ventricular (LV) wall in apical segments.
To study the relationship between regional functional measurements and the TEI at the basal, mid-ventricular and apical levels of the LV.
Fifty-eight patients (44 male, age 58(8) yrs) underwent MRI 32(12) days after a first time STEMI involving the LAD (42%), CX (22%) and RCA (36%). Wall thickness and -thickening were quantified by cine short-axis ssfp-images at 1-cm intervals throughout the LV. TEI was measured using a phase-sensitive inversion recovery sequence in the same slices as the functional imaging, 10 min after a bolus of 0.15 mmol/kg gadodiamid. Infarcted myocardium was quantified using a cut-off of 2 SD relative to remote myocardium. All analyses were performed in the Segment software, using the 16 segment AHA model of the LV.
During the subacute phase after a first-time STEMI, the relationship between segmental infarct transmurality and segmental wall thickening is moderately strong, and not different at the basal, midventricular and apical levels of the LV. End-diastolic wall thickness cannot be used to predict infarct transmurality during this phase.
This article is published under license to BioMed Central Ltd.