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. 2008 Apr 9;10(1):17.
doi: 10.1186/1532-429X-10-17.

Quantitative characterization of myocardial infarction by cardiovascular magnetic resonance predicts future cardiovascular events in patients with ischemic cardiomyopathy

Hajime Yokota  1 , Shahriar Heidary, Chandra K Katikireddy, Patricia Nguyen, John M Pauly, Michael V McConnell, Phillip C Yang
Affiliations

Quantitative characterization of myocardial infarction by cardiovascular magnetic resonance predicts future cardiovascular events in patients with ischemic cardiomyopathy

Hajime Yokota et al. J Cardiovasc Magn Reson. .

Abstract

Background: Cardiovascular magnetic resonance (CMR) can provide quantitative data of the myocardial tissue utilizing high spatial and temporal resolution along with exquisite tissue contrast. Previous studies have correlated myocardial scar tissue with the occurrence of ventricular arrhythmia. This study was conducted to evaluate whether characterization of myocardial infarction by CMR can predict cardiovascular events in patients with ischemic cardiomyopathy (ICM).

Results: We consecutively studied 86 patients with ICM (LVEF < 50%, mean LVEF: 26 +/- 12%) with CMR before revascularization or medication therapy +/- implantable cardiac defibrillator, determined the amount of myocardial scar, and followed for development of cardiovascular events. Thirty-three patients (38%) had cardiovascular events (mean follow-up: 20 +/- 16 months). Patients who developed cardiovascular events had larger scar volume and scar percentage of the myocardium than those who did not develop cardiovascular events (16.8 +/- 12.4 cm3 vs. 11.7 +/- 12.6 cm3, p = 0.023 and 10.2 +/- 6.9% vs. 7.2 +/- 6.7%, p = 0.037, respectively). There were no significant differences in LVEDV, LVESV and LVEF between the patients with and without cardiovascular events (231 +/- 76 ml vs. 230 +/- 88 ml; 180 +/- 73 ml vs. 175 +/- 90 ml; and 25 +/- 10% vs. 27 +/- 13%, respectively).

Conclusion: Quantification of the scar volume and scar percentage by CMR is superior to LVEDV, LVESV, and LVEF in prognosticating the future likelihood of the development of cardiovascular events in patients with ICM.

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Figures

Figure 1
Figure 1
Cardiac magnetic resonance characterization of myocardial infarction. The total myocardial and scar area in each of the 8 to 11 short-axis images were traced manually. Myocardial and scar volume for each slice were calculated as (area myocardium or area scar × slice thickness of 10 mm). The scar percentage of myocardium was also expressed as a percentage of the total myocardial volume (Volume scar/Volume myocardium × 100).
Figure 2
Figure 2
The correlation between left ventricular volumes and the scar volume and scar percentage. The correlation of LVEF with scar volume (a) and scar percentage of the myocardium (b).
Figure 3
Figure 3
The correlation between left ventricular volumes and the scar volume and scar percentage. The correlation of LVEDV with scar volume (a) and scar percentage of the myocardium (b).
Figure 4
Figure 4
The correlation between left ventricular volumes and the scar volume and scar percentage. The correlation of LVESV with scar volume (a) and scar percentage of the myocardium (b).
See this image and copyright information in PMC

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