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European Radiology

, Volume 21, Issue 4, pp 693–701 | Cite as

Time course of infarct healing and left ventricular remodelling in patients with reperfused ST segment elevation myocardial infarction using comprehensive magnetic resonance imaging

  • Javier Ganame
  • Giancarlo Messalli
  • Pier Giorgio Masci
  • Steven Dymarkowski
  • Kayvan Abbasi
  • Frans Van de Werf
  • Stefan Janssens
  • Jan BogaertEmail author
Cardiac

Abstract

Objective

To describe the time course of myocardial infarct (MI) healing and left ventricular (LV) remodelling and to assess factors predicting LV remodelling using cardiac MRI.

Methods

In 58 successfully reperfused MI patients, MRI was performed at baseline, 4 months (4M), and 1 year (1Y) post MI

Results

Infarct size decreased between baseline and 4M (p < 0.001), but not at 1Y; i.e. 18 ± 11%, 12 ± 8%, 11 ± 6% of LV mass respectively; this was associated with LV mass reduction. Infarct and adjacent wall thinning was found at 4M, whereas significant remote wall thinning was measured at 1Y. LV end-diastolic and end-systolic volumes significantly increased at 1Y, p < 0.05 at 1Y vs. baseline and vs. 4M; this was associated with increased LV sphericity index. No regional or global LV functional improvement was found at follow-up. Baseline infarct size was the strongest predictor of adverse LV remodelling.

Conclusions

Infarct healing, with shrinkage of infarcted myocardium and wall thinning, occurs early post-MI as reflected by loss in LV mass and adjacent myocardial remodelling. Longer follow-up demonstrates ongoing remote myocardial and ventricular remodelling. Infarct size at baseline predicts long-term LV remodelling and represents an important parameter for tailoring future post-MI pharmacological therapies designed to prevent heart failure.

Keywords

Myocardial infarction Magnetic resonance Imaging Left ventricular function Remodelling Myocardium 

Notes

Acknowledgements

This study was partially funded by FWO grant G.06113.09

Supplementary material

330_2010_1963_MOESM1_ESM.wmv (153 kb)
Movie 1. Balanced SSFP cine images along the horizontal long axis corresponding to the patient shown in Fig. 3 obtained at 1 week (movie 1) (WMV 153 kb)
330_2010_1963_MOESM2_ESM.wmv (153 kb)
Movie 2. Balanced SSFP cine images along the horizontal long axis corresponding to the patient shown in Fig. 3 obtained at 4 months (movie 2) (WMV 153 kb)
330_2010_1963_MOESM3_ESM.wmv (169 kb)
Movie 3. Balanced SSFP cine images along the horizontal long axis corresponding to the patient shown in Fig. 3 obtained at 1 year (movie 3). (WMV 168 kb)

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Copyright information

© European Society of Radiology 2010

Authors and Affiliations

  • Javier Ganame
    • 1
    • 2
  • Giancarlo Messalli
    • 2
  • Pier Giorgio Masci
    • 2
    • 3
  • Steven Dymarkowski
    • 2
  • Kayvan Abbasi
    • 2
  • Frans Van de Werf
    • 1
  • Stefan Janssens
    • 1
  • Jan Bogaert
    • 2
    Email author
  1. 1.Cardiology DepartmentUniversity Hospitals LeuvenLeuvenBelgium
  2. 2.Radiology DepartmentUniversity Hospitals LeuvenLeuvenBelgium
  3. 3.MRI unit, Monasterio Foundation CNRPisaItaly

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