- Poster presentation
- Open Access
Chronic iron deposit and left ventricular remodeling in reperfused STEMI patients
© Bulluck et al. 2016
- Published: 27 January 2016
- Late Gadolinium Enhancement
- Ventricular Remodel
- Iron Deposit
- Left Ventricular Remodel
- STEMI Patient
After reperfused ST-segment elevation myocardial infarction (STEMI), infarct zone microvascular obstruction (MVO) and intramyocardial hemorrhage are associated with left ventricular (LV) remodeling. We wanted to understand what happened to areas of haemorrhage and observe its resolution/persistence and any role it may play in remodeling.
48 STEMI patients underwent CMR imaging at 1.5T (Siemens Avanto) at 4 ± 2 days post-PPCI and 40 completed a follow-up scan at 5 ± 2 months. Left ventricular (LV) short-axis native T1 (MOLLI), T2 and T2* maps were acquired. MVO was indicated by a hypo-intense core on LGE images. A hypo-intense core on T2*-maps with a T2*<20 ms was used for IMH (acutely) or chronic iron deposit (at follow-up). Mean segmental T2 and T1 values were obtained using CVI42 (Calgary, Canada). LV remodeling was defined as a 20% increase in LV end-diastolic volume on the follow-up scans.
T1 and T2-mapping can detect hemorrhage.
Acute hemorrhage becomes chronic and is still detectable at 5 months
Infarct T2 normalizes usually by 3-6 months in most patients - but around chronic iron the T2 remains high - suggesting the iron may be a source of ongoing inflammation.
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