Myocardial strain in sub-acute peri-infarct myocardium

Balázs Ruzsics, Pál Surányi, Pál Kiss, Brigitta C. Brott, Silvio Litovsky, Thomas S. Denney, Inmaculada Aban, Steven G. Lloyd, Tamas Simor, Gabriel A. Elgavish, Himanshu Gupta

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Abstract

Purpose: In the absence of additional ischemic insults, the peri-infarct region surrounding the infarct myocardium can recover function. T2 weighted MRI signal is sensitive to edema and used to detect peri-infarct, salvageable myocardium. The main purpose of this study was to investigate the alterations in myocardial strain in the peri-infarct myocardium as compared to normal and infarct myocardium. Materials and methods: Comprehensive MRI of the myocardium was performed in five pigs 6-7 days following coronary artery occlusion-reperfusion myocardial injury. MRI included tagged cine images for myocardial strain, T2weighted (T2w)-images and late gadolinium enhancement (LGE) for assessing myocardial viability. Automated signal intensity thresholds were used to define tissue edema and myocardial infarct. Maximum-shortening strains were analyzed in the infarct, peri-infarct and normal myocardial sectors. The results were correlated with triphenyltetrazolium-chloride (TTC) and hemotoxylin-eosin stained tissue images. Results: We found an excellent correlation of LGE with TTC (r =0.94, P < 0.05). T2w-images markedly overestimated the infarct size (25 ± 3%). Both the healthy and peri-infarct myocardial sectors had higher myocardial strain than infarct myocardial sectors (P < 0.05). Clear demarcation between infarct and non-infarct myocardium was noted on histology. Conclusion: Peri-infarct myocardium continues to demonstrate T2 signal enhancement to at least 7 days, but this region has preserved mechanical function. T2-weighted imaging and myocardial strain measurements provide complementary information and both may be useful for characterization of the peri-infarct myocardium.

Original languageEnglish
Pages (from-to)151-159
Number of pages9
JournalInternational Journal of Cardiovascular Imaging
Volume25
Issue number2
DOIs
Publication statusPublished - Jan 1 2009

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Keywords

  • Delayed enhancement
  • Magnetic resonance imaging
  • Myocardial perfusion
  • Myocardial strain
  • Peri-infarct myocardium

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Ruzsics, B., Surányi, P., Kiss, P., Brott, B. C., Litovsky, S., Denney, T. S., Aban, I., Lloyd, S. G., Simor, T., Elgavish, G. A., & Gupta, H. (2009). Myocardial strain in sub-acute peri-infarct myocardium. International Journal of Cardiovascular Imaging, 25(2), 151-159. https://doi.org/10.1007/s10554-008-9364-7