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Volume 18 Supplement 1

19th Annual SCMR Scientific Sessions

  • Poster presentation
  • Open Access

Biomarker validation of cardiac magnetic resonance analysis of regional myocardial fibrosis in ischaemic heart disease

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Journal of Cardiovascular Magnetic Resonance201618 (Suppl 1) :P77

  • Published:


  • Cardiac Magnetic Resonance
  • Late Gadolinium Enhancement
  • Myocardial Fibrosis
  • Automate Threshold
  • Segment Elevation Myocardial Infarction


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.
Figure 1
Figure 1

Correlation between infarct size assessment using biomarkers and CMR-LGE.

Authors’ Affiliations

Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia
Alfred Hospital, Melbourne, VIC, Australia
Monash University, Melbourne, VIC, Australia
Ambulance Victoria, Melbourne, VIC, Australia
Monash Heart, Melbourne, VIC, Australia


© Costello et al. 2016

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.