Introduction
Methods
Patient population
Cardiac magnetic resonance
Imaging method | Cine | ShMOLLI T1 maps | LGE |
---|---|---|---|
Sequence | SSFP | 5–7 SSFP images | T1-weighted GRE_PSIR |
TR, ms | 3.2 | 2.14 | 5 |
TE, ms | 1.4 | 1.07 | 2.5 |
Flip angle | 50° | 35° | 20° |
In-plane resolution | 1.6 × 1.6 | 1.8 × 1.8 | 1.8 × 1.4 |
Slice thickness, mm | 8 | 8 | 8 |
Other parameters | Optimal T1 to null the remote myocardium |
CMR imaging analysis
Global analysis
Segmental analysis
Statistical analysis
Results
Mean ± SD | |
---|---|
Age, year | 60 ± 11 |
Sex, M/F | 68/28 |
Risk factors, n (%) | |
Diabetes | 10 (10) |
Smoker | 26 (27) |
Hypertension | 33 (34) |
Hyperlipidaemia | 34 (35) |
Family history of CHD | 35 (36) |
Target vessel n (%) | |
LAD | 43 (45) |
LCx | 7 (7) |
RCA | 26 (27) |
Peak troponin (mg/l) | 206 ± 290 |
Pain to Balloon time (mins) | 242 ± 180 |
PPCI to CMR time (h) | 53 ± 36 |
No. of vessels diseased, n (%) | |
1 | 72 (75) |
2 | 17 (19) |
3 | 7 (6) |
TIMI flow pre PCI, n (%) | |
0 | 66 (80) |
1 | 5 (6) |
2 | 10 (12) |
3 | 1 (1) |
TIMI flow post PCI, n (%) | |
1 | 1 (1) |
2 | 4 (5) |
3 | 68 (93) |
CMR findings
Acute mean ± SD (n = 96) | 6M mean ± SD (n = 59) | p-Value | |
---|---|---|---|
EF (%) | 46 ± 8 | 51 ± 9 | < 0.001 |
EDV (ml) | 164 ± 43 | 163 ± 39 | 0.9 |
ESV (ml) | 89 ± 33 | 78 ± 31 | < 0.01 |
SV (ml) | 73 ± 20 | 86 ± 18 | < 0.01 |
Oedema by T1-mapping, (%LV) | 42 ± 14 | ||
LGE, (%LV) | 24 ± 14 | 16 ± 10 | < 0.001 |
Myocardial salvage index [(Oedema%LV-%LV LGE)/Oedema %LV] | 47 ± 22 | ||
MVO (%LV) | 2 ± 3 | ||
Global LV T1 (ms) | 1280 ± 47 | 1214 ± 75 | < 0.001 |
Global circumferential strain (%) | − 16.6 ± 3.8 | ||
Global radial strain (%) | 29.6 ± 9 |
Segmental analysis
Infarct | Adjacent | Remote | p Value | p Value | ||
---|---|---|---|---|---|---|
n = 1050 | n = 931 | n = 1434 | (infarct vs. remote) | (adjacent vs. remote) | ||
Acute CMR | T1 (ms) | 1357 ± 89 | 1245 ± 100 | 1215 ± 87 | < 0.001 | < 0.001 |
LGE (%) | 52 ± 53 | 0 ± 6 | 0 ± 0 | < 0.001 | < 0.001 | |
Err (%) | 12 (13) | 27 (19) | 35 (23) | < 0.001 | < 0.01 | |
Ecc (%) | − 10 (9) | − 17 (8) | − 20 (9) | < 0.001 | 0.07 | |
6M CMR | T1 (ms) | 1235 ± 99 | 1193 ± 66 | 1185 ± 66 | < 0.001 | 0.387 |
LGE (%) | 36 (56) | 0 (5) | 0 (0) | < 0.001 | < 0.001 |
Relationship between severity of ischemic injury and strain
LGE < 25% | LGE 25–50% | LGE 50–75% | LGE ≥ 75% | p Value | ||
---|---|---|---|---|---|---|
n = 2538 | n = 319 | n = 225 | n = 333 | (difference between groups) | ||
Acute CMR | T1 (ms) | 1229 ± 94 | 1332 ± 86 | 1374 ± 91 | 1378 ± 84 | < 0.001 |
Err (%) | 31.4 (25) | 14 (15) | 11 (10) | 8.8 (9) | < 0.001 | |
Ecc (%) | − 19 (10) | − 12 (10) | − 10 (8) | − 7.5 (7) | < 0.001 | |
6M CMR | T1 (ms) | 1197 ± 68 | 1210 ± 83 | 1245 ± 96 | 1268 ± 87 | < 0.001 |
p Value (acute vs. 6M T1) | < 0.001 | < 0.001 | < 0.001 | < 0.001 |
T1 vs. Err | T1 vs. Ecc | LGE vs. Err | LGE vs. Ecc | |
---|---|---|---|---|
Mean ± SD | − 0.75 ± 0.25 | 0.72 ± 0.32 | − 0.56 ± 0.29 | 0.54 ± 0.35 |
p Value | p < 0.001 | p < 0.001 | p < 0.001 | p < 0.001 |
n Patients | 96 | 96 | 96 | 96 |
Segments | 3773 | 3773 | 3773 | 3773 |