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Determination of the myocardial area at risk with pre- versus post-reperfusion imaging techniques in the pig model

Basic Research in Cardiology volume 106, pages 1247–1257 (2011)Cite this article

Abstract

The purpose of this study was to compare the accuracy of post-reperfusion cardiac magnetic resonance (CMR) and pre-reperfusion multidetector computed tomography (MDCT) imaging to measure the size of the area at risk (AAR), using pathology as a reference technique in a porcine acute myocardial infarction model. Fifteen pigs underwent balloon-induced coronary artery occlusion for 40 min followed by reperfusion. The AAR was assessed with arterial enhanced MDCT performed during occlusion, while two different T2 weighted (T2W) CMR imaging sequences and the contrast-enhanced (ce-) CMR endocardial surface length (ESL) were performed after 90 min of reperfusion. Animals were euthanized and the AAR was assessed by pathology. Additional measurements of the myocardial water content in the AAR, remote and the AAR border zones were performed. AAR by pathology best correlated with measurements made by MDCT (R 2 = 0.88; p < 0.001) with little bias on Bland–Altman plots (bias 2.5%, SD 6.1% LV area). AAR measurements obtained by T2W STIR, T2W ACUTE sequences or the ESL on ce-CMR showed a fair correlation with pathology (R 2 = 0.72, R 2 = 0.65 and R 2 = 0.69, respectively; all p ≤ 0.001), but significantly overestimated the size of the AAR with important bias (17.4 ± 10.8% LV area; 11.7 ± 11.0% LV area; 13.0 ± 10.3% LV area, respectively). The myocardial water content in the AAR border zones was significantly higher than the remote (82.8 vs. 78.8%; p < 0.001). Our data suggest that post-reperfusion imaging methods overestimated the AAR likely due to the presence of edema outside of the boundaries of the AAR. Pre-reperfusion arterial enhanced MDCT showed the greatest accuracy for the assessment of the AAR.

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Acknowledgments

Dr. Nathan Mewton was supported by a research grant from the French Federation of Cardiology for this project.

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Affiliations

  1. Service d’Explorations Fonctionnelles Cardiovasculaires, Hôpital Louis Pradel, Hospices Civils de Lyon, Lyon, France

    Nathan Mewton & Michel Ovize

  2. Inserm U1060 (CARMEN), Université Claude Bernard Lyon 1, Lyon, France

    Nathan Mewton, Lionel Augeul, René Ferrera, Joseph Loufouat, Gilles Rioufol & Michel Ovize

  3. CREATIS-LRMN, CNRS UMR 5220, INSERM U630, Université Claude Bernard Lyon 1, Lyon, France

    Stanislas Rapacchi, Loic Boussel, Alejandra Micolich, Didier Revel & Pierre Croisille

  4. Department of Cardiology, Hôpital Cardiologique Louis Pradel, 28 avenue Doyen Lépine, 69500, Bron, France

    Michel Ovize

  5. Department of Radiology, Hôpital Louis Pradel, 28 avenue Doyen Lépine, 69500, Bron, France

    Loic Boussel, Didier Revel & Pierre Croisille

  6. Department of Interventional Cardiology, Hôpital Louis Pradel, 28 avenue Doyen Lépine, 69500, Bron, France

    Gilles Rioufol

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  1. Nathan Mewton
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Correspondence to Michel Ovize.

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Mewton, N., Rapacchi, S., Augeul, L. et al. Determination of the myocardial area at risk with pre- versus post-reperfusion imaging techniques in the pig model. Basic Res Cardiol 106, 1247–1257 (2011). https://doi.org/10.1007/s00395-011-0214-8

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Keywords

  • Infarction
  • Reperfusion
  • Area at risk