Biomarker validation of cardiac magnetic resonance analysis of regional myocardial fibrosis in ischaemic heart disease
Journal of Cardiovascular Magnetic Resonance volume 18, Article number: P77 (2016)
Late gadolinium enhancement (LGE) with CMR is commonly assumed to represent myocardial fibrosis; however, comparative human histological data are limited, and there is no consensus on the most accurate method for LGE quantitation. We evaluated the relationship between CMR assessment of regional fibrosis and infarct size assessment using serial biomarkers after ST segment elevation myocardial infarction (STEMI).
Ninety-five patients treated for STEMI (59 ± 10 years, 85% male) underwent CMR six months after infarction. Fibrosis was quantified by CMR-LGE using visual and automated thresholds, and compared with the rise in serum biomarkers.
Quantification methods had a strong influence on the infarct size assessment with CMR-LGE. Significant correlations were observed between LGE and biomarkers across a range of signal intensity thresholds (range: 2-10 standard deviations [SD] above reference myocardium), however there was a wide range with respect to estimation of total LGE size (from 6.8 ± 7.7 to 32.1 ± 11.3 grams) and a smaller variation in the correlation with peak troponin level (R-values ranging from 0.715 to 0.834). The strongest correlation was observed at thresholds of 5 and 6 SD (R = 0.830, P < 0.001 and R = 0.834, P < 0.001).
There is a wide variation for the correlation between CMR-LGE quantification of infarct size and biomarker release following STEMI at a range of automated thresholds, with the strongest correlations at 5SD and 6SD thresholds.
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Costello, B.T., Iles, L.M., Stub, D. et al. Biomarker validation of cardiac magnetic resonance analysis of regional myocardial fibrosis in ischaemic heart disease. J Cardiovasc Magn Reson 18 (Suppl 1), P77 (2016). https://doi.org/10.1186/1532-429X-18-S1-P77