BOLD cardiac MRI for differentiating reversible and irreversible myocardial damage in ST segment elevation myocardial infarction
BOLD imaging is a quantitative MRI technique allowing the evaluation of the balance between supply/demand in myocardial oxygenation and myocardial haemorrhage. We sought to investigate the ability of BOLD imaging to differentiate reversible from irreversible myocardial injury as well as the chronological progression of myocardial oxygenation after reperfusion in patients with ST segment elevation myocardial infarction (STEMI).
Twenty-two patients (age, 60 ± 11 years; 77.3% male) with STEMI underwent cardiac MRIs on four occasions: on days 1, 3, 7 and 30 after reperfusion. BOLD MRI was obtained with a multi-echo turbo field echo (TFE) sequence on a 3-T scanner to assess myocardial oxygenation in MI.
T2* value in MI with intramyocardial haemorrhage (IMH) was the lowest (9.77 ± 3.29 ms), while that of the salvaged zone was the highest (33.97 ± 3.42 ms). T2* values in salvaged myocardium demonstrated a unimodal temporal pattern from days 1 (37.91 ± 2.23 ms) to 30 (30.68 ± 1.59 ms). T2* values in the MI regions were significantly lower than those in remote myocardium, although the trends in both were constant overall. There was a slightly positive correlation between T2* in MI regions and EF (Rho = 0.27, p < 0.05) or SV (Rho = 0.22, p = 0.04) and a slightly negative correlation between T2* in salvaged myocardium and LVEDV (Rho = – 0.23, p < 0.05).
BOLD MRI performed in post-STEMI patients allows accurate evaluation of myocardial damage severity and could differentiate reversible from irreversible myocardial injury. The increased T2* values may imply the pathophysiological mechanism of salvaged myocardium. BOLD MRI could represent a more accurate alternative to the other currently available options.
• Myocardial oxygenation and haemorrhage after myocardial infarction affect BOLD MRI values
• BOLD MRI could be used to differentiate irreversible from reversible myocardial damage
• Changed oxygenation implies the pathophysiological mechanism of salvaged myocardium
KeywordsMagnetic resonance imaging ST elevation myocardial infarction Reperfusion Myocardium Haemoglobins
Blood oxygen level-dependent
Full width at half maximum
Late gadolinium enhancement
Magnetic resonance imaging
Percutaneous coronary intervention
Region of interest
Steady-state free precession
ST segment elevation myocardial infarction
T2-weighted short-tau triple inversion recovery
Shanghai Municipal Commission of Health and Family Planning excellent young talent program (No. 2017YQ031), Renji Hospital Clinical Training Fund (PYEY16-001), Shanghai talent development fund (201559), Shanghai young doctor training program, Shanghai Jiao Tong University “Chen-Xing B” program.
Compliance with ethical standards
The scientific guarantor of this publication is Lian-Ming Wu.
Conflict of interest
The authors state that there neither exists a conflict of interest nor that there is financial information to disclose.
Statistics and biometry
Lian-Ming Wu kindly provided statistical advice for this manuscript.
Written informed consent was obtained from all participants in this study.
Institutional review board approval was obtained.
• single-centre study
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