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Myocardial strain in sub-acute peri-infarct myocardium

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Abstract

Purpose In the absence of additional ischemic insults, the peri-infarct region surrounding the infarct myocardium can recover function. T2 weighted MRI signal is sensitive to edema and used to detect peri-infarct, salvageable myocardium. The main purpose of this study was to investigate the alterations in myocardial strain in the peri-infarct myocardium as compared to normal and infarct myocardium. Materials and methods Comprehensive MRI of the myocardium was performed in five pigs 6–7 days following coronary artery occlusion–reperfusion myocardial injury. MRI included tagged cine images for myocardial strain, T2weighted (T2w)-images and late gadolinium enhancement (LGE) for assessing myocardial viability. Automated signal intensity thresholds were used to define tissue edema and myocardial infarct. Maximum-shortening strains were analyzed in the infarct, peri-infarct and normal myocardial sectors. The results were correlated with triphenyltetrazolium-chloride (TTC) and hemotoxylin–eosin stained tissue images. Results We found an excellent correlation of LGE with TTC (r = 0.94, P < 0.05). T2w-images markedly overestimated the infarct size (25 ± 3%). Both the healthy and peri-infarct myocardial sectors had higher myocardial strain than infarct myocardial sectors (P < 0.05). Clear demarcation between infarct and non-infarct myocardium was noted on histology. Conclusion Peri-infarct myocardium continues to demonstrate T2 signal enhancement to at least 7 days, but this region has preserved mechanical function. T2-weighted imaging and myocardial strain measurements provide complementary information and both may be useful for characterization of the peri-infarct myocardium.

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Acknowledgments

This study was partially supported by Specialized Center for Clinically Oriented Research in Cardiac Dysfunction P50HL077100. Disclosure: Pál Surányi and Pál Kiss were employees at and Gabriel A. Elgavish is the president of Elgavish Paramagnetics Inc., Birmingham, AL 35226, USA.

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Authors and Affiliations

  1. Department of Biochemistry and Molecular Genetics, University of Alabama, Birmingham, AL, USA

    Balázs Ruzsics, Pál Surányi, Pál Kiss, Tamas Simor & Gabriel A. Elgavish

  2. Department of Medicine, Division of Cardiovascular Disease, CVMRI, University of Alabama, BDB 101, 1808 7th Avenue South, Birmingham, AL, 35294, USA

    Brigitta C. Brott, Steven G. Lloyd, Gabriel A. Elgavish & Himanshu Gupta

  3. Department of Anatomic Pathology, University of Alabama, Birmingham, AL, USA

    Silvio Litovsky

  4. Department of Electrical and Computer Engineering, Auburn University, Auburn, AL, USA

    Thomas S. Denney Jr.

  5. Department of Biostatistics, University of Alabama, Birmingham, AL, USA

    Inmaculada Aban

Authors
  1. Balázs Ruzsics
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  2. Pál Surányi
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  3. Pál Kiss
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  4. Brigitta C. Brott
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  5. Silvio Litovsky
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  6. Thomas S. Denney Jr.
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  7. Inmaculada Aban
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  8. Steven G. Lloyd
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  9. Tamas Simor
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  10. Gabriel A. Elgavish
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  11. Himanshu Gupta
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Correspondence to Himanshu Gupta.

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Balázs Ruzsics and Pál Surányi have contributed equally.

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Ruzsics, B., Surányi, P., Kiss, P. et al. Myocardial strain in sub-acute peri-infarct myocardium. Int J Cardiovasc Imaging 25, 151–159 (2009). https://doi.org/10.1007/s10554-008-9364-7

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  • DOI: https://doi.org/10.1007/s10554-008-9364-7

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