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

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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.

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Acknowledgements

This study was partially funded by FWO grant G.06113.09

Author information

Authors and Affiliations

  1. Cardiology Department, University Hospitals Leuven, Leuven, Belgium

    Javier Ganame, Frans Van de Werf & Stefan Janssens

  2. Radiology Department, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium

    Javier Ganame, Giancarlo Messalli, Pier Giorgio Masci, Steven Dymarkowski, Kayvan Abbasi & Jan Bogaert

  3. MRI unit, Monasterio Foundation CNR, Pisa, Italy

    Pier Giorgio Masci

Authors
  1. Javier Ganame
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  2. Giancarlo Messalli
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  3. Pier Giorgio Masci
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  4. Steven Dymarkowski
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  5. Kayvan Abbasi
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  6. Frans Van de Werf
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  7. Stefan Janssens
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  8. Jan Bogaert
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Corresponding author

Correspondence to Jan Bogaert.

Additional information

Javier Ganame and Giancarlo Messalli contributed equally to this study.

Electronic supplementary material

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330_2010_1963_MOESM1_ESM.wmv

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

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

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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Ganame, J., Messalli, G., Masci, P.G. et al. Time course of infarct healing and left ventricular remodelling in patients with reperfused ST segment elevation myocardial infarction using comprehensive magnetic resonance imaging. Eur Radiol 21, 693–701 (2011). https://doi.org/10.1007/s00330-010-1963-8

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  • DOI: https://doi.org/10.1007/s00330-010-1963-8

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