Myocardial haemorrhage after acute reperfused ST-elevation myocardial infarction evolves progressively and contributes to the early bimodal pattern in T2-relaxation time: advanced imaging and clinical significance
Journal of Cardiovascular Magnetic Resonance volume 18, Article number: P231 (2016)
The time-course and relationships of myocardial haemorrhage and oedema in survivors of acute ST-elevation myocardial infarction (STEMI) are uncertain.
30 STEMI patients (mean age 54 years; 25(83%) male) treated by primary percutaneous coronary intervention underwent serial cardiac magnetic resonance imaging: 4 - 12 hours, 3 days, 10 days and 7 months post-reperfusion. Native T2 and T2* were measured in regions-of-interest in remote and injured myocardium. Myocardial haemorrhage was taken to represent a hypointense infarct core with a T2* value <20 ms. Public registration: NCT02072850.
Myocardial haemorrhage occurred in 7(23%), 13(43%), 11(33%), and 4(13%) patients at 4 - 12 hours, 3 days, 10 days and 7 months, consistent with a unimodal pattern. The corresponding amounts of myocardial haemorrhage (% LV mass) during the first 10 days post-MI were (median, IQR): 2.7(0.0, 5.6), 7.0(4.9, 7.5), 4.1(2.6, 5.5); p < 0.001). Myocardial oedema (% LV mass) had a unimodal evolution in all patients (p=0.001). In patients without hemorrhage, infarct zone T2 values (ms) increased progressively during the first 10 days (62.1(2.9), 64.4(4.9), 65.9(5.3) (p < 0.001). Alternatively, in patients with myocardial haemorrhage, infarct zone T2 was reduced at day 3 (51.8 (4.6) ms) (p < 0.001), depicting a bimodal pattern.
LV end-diastolic volume increased from baseline to 7 months in patients with myocardial haemorrhage (p=0.001), but not in patients without haemorrhage (p=0.377).
The temporal evolutions of myocardial haemorrhage and oedema are unimodal, whereas infarct zone T2 (ms) has a bimodal pattern in haemorrhagic infarction. Myocardial haemorrhage is prognostically important. Further studies are warranted.
About this article
Cite this article
Carrick, D., Haig, C., Ahmed, N. et al. Myocardial haemorrhage after acute reperfused ST-elevation myocardial infarction evolves progressively and contributes to the early bimodal pattern in T2-relaxation time: advanced imaging and clinical significance. J Cardiovasc Magn Reson 18 (Suppl 1), P231 (2016). https://doi.org/10.1186/1532-429X-18-S1-P231