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Remodeling of the infarct territory in the time course of infarct healing in humans

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Abstract

Object

To analyze the remodeling processes of the infarct territory in the time course of infarct healing.

Materials and methods

Serial late enhancement (LE) studies were performed in 30 patients following reperfused myocardial infarction (MI) in the first and second week post-MI and after 3 months. To characterize infarct remodeling over time, the following variables were derived and analyzed in a blinded fashion: Infarct size (IS, in mm3), maximum infarct thickness (ITmax, mm), mean infarct thickness (ITmean, mm) and the variability of infarct thickness (VIT=ITmax/ITmean). Further, a new parameter for the assessment of infarct remodeling, the infarct extent (IE, mm2) was computed. IE quantifies IS in two dimensions along the heart’s circumferential and longitudinal directions. IS was divided by the IE to obtain ITmean.

Results

Overall infarct thickness was highly variable. Infarct shrinkage due to infarct thinning and IE reduction was found in the first months of healing. IS, ITmean and ITmax significantly decreased during follow-up. There was a less consistent change of the IE: IE decreased in 75% of all infarcts from the first week up to 3 months post-MI, whereas 25% of infarcts expanded. Infarct thinning was found in almost all patients (92%), hence occurring in patients with infarct expansion and in patients without infarct expansion.

Conclusion

Infarct thinning and—to a lesser extent—IE reduction, contribute to infarct shrinkage in the time course of infarct healing. Infarct thinning may occur without infarct expansion.

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Abbreviations

LE:

Late enhancement

MI:

Myocardial infarction

IS:

Infarct size

IE:

Infarct extent

ITmax :

Maximum radial infarct thickness

ITmean :

Mean radial infarct thickness

VIT:

Variability of infarct thickness

C:

Circumferential extent of infarct

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Authors and Affiliations

  1. Department of Internal Medicine I, Center of Cardiovascular Medicine, University Hospital Würzburg, Oberdürrbacher-Str. 6, 97080, Würzburg, Germany

    Hanns B. Hillenbrand, Stefan Störk, Benjamin Ramsayer, Georg Ertl & Wolfgang Bauer

  2. Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany

    Hanns B. Hillenbrand, Stefan Störk, Dietbert Hahn, Georg Ertl, Herbert Koestler & Wolfgang Bauer

  3. Institute of Radiology, University Hospital Würzburg, Würzburg, Germany

    Joern Sandstede, Dietbert Hahn, Herbert Koestler & Christian Ritter

Authors
  1. Hanns B. Hillenbrand
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  2. Joern Sandstede
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  3. Stefan Störk
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  4. Benjamin Ramsayer
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  5. Dietbert Hahn
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  6. Georg Ertl
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  7. Herbert Koestler
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  8. Wolfgang Bauer
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  9. Christian Ritter
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Correspondence to Hanns B. Hillenbrand.

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Hillenbrand, H.B., Sandstede, J., Störk, S. et al. Remodeling of the infarct territory in the time course of infarct healing in humans. Magn Reson Mater Phy 24, 277–284 (2011). https://doi.org/10.1007/s10334-011-0262-y

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  • DOI: https://doi.org/10.1007/s10334-011-0262-y

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