Regional wall function before and after acute myocardial infarction; an experimental study in pigs

BMC Cardiovascular Disorders

Research Article

Joey FA Ubachs¹  Matthias Götberg²  David Erlinge²  Ulrika S Pahlm³  Håkan Arheden³  Henrik Engblom³  Einar Heiberg⁴ 

[1] Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands;Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden;Department of Clinical Physiology, Clinical Sciences, Lund University Hospital, SE-22185, Lund, Sweden;Department of Clinical Physiology, Clinical Sciences, Lund University Hospital, SE-22185, Lund, Sweden;Centre for Mathematical Sciences, Lund University, Lund, Sweden;Department of Biomedical Engineering, Faculty of Engineering, Lund University, Lund, Sweden;

关键词: Cardiac Magnetic Resonance;    Acute Myocardial Infarction;    Late Gadolinium Enhancement;    Longitudinal Strain;    Radial Strain;   

DOI  :  10.1186/1471-2261-14-118

 received in 2014-03-23, accepted in 2014-09-09,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundLeft ventricular function is altered during and after AMI. Regional function can be determined by cardiac magnetic resonance (CMR) wall thickening, and velocity encoded (VE) strain analysis. The aims of this study were to investigate how regional myocardial wall function, assessed by CMR VE-strain and regional wall thickening, changes after acute myocardial infarction, and to determine if we could differentiate between ischemic, adjacent and remote segments of the left ventricle.MethodsTen pigs underwent baseline CMR study for assessment of wall thickening and VE-strain. Ischemia was then induced for 40-minutes by intracoronary balloon inflation in the left anterior descending coronary artery. During occlusion, 99mTc tetrofosmin was administered intravenously and myocardial perfusion SPECT (MPS) was performed for determination of the ischemic area, followed by a second CMR study. Based on ischemia seen on MPS, the 17 AHA segments of the left ventricle was divided into 3 different categories (ischemic, adjacent and remote). Regional wall function measured by wall thickening and VE-strain analysis was determined before and after ischemia.ResultsMean wall thickening decreased significantly in the ischemic (from 2.7 mm to 0.65 mm, p < 0.001) and adjacent segments (from 2.4 to 1.5 mm p < 0.001). In remote segments, wall thickening increased significantly (from 2.4 mm to 2.8 mm, p < 0.01). In ischemic and adjacent segments, both radial and longitudinal strain was significantly decreased after ischemia (p < 0.001). In remote segments there was a significant increase in radial strain (p = 0.002) while there was no difference in longitudinal strain (p = 0.69). ROC analysis was performed to determine thresholds distinguishing between the different regions. Sensitivity for determining ischemic segments ranged from 70-80%, and specificity from 72%-77%. There was a 9% increase in left ventricular mass after ischemia.ConclusionDifferentiation thresholds for wall thickening and VE-strain could be established to distinguish between ischemic, adjacent and remote segments but will, have limited applicability due to low sensitivity and specificity. There is a slight increase in radial strain in remote segments after ischemia. Edema was present mainly in the ischemic region but also in the combined adjacent and remote segments.

【 授权许可】

Unknown   
© Pahlm et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.