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Date Published: 15/06/2022
Online Published: 26/02/2020
Abstract Views: 125
Views PDF: 71
DOI: https://doi.org/10.55046/vjrnm.37.146.2020
Issue
No. 37 (2020)
Section
Scientific research
How to Cite
Nguyen, K. V., Vu, D. L., & Nguyen, Q. D. (2020). Role of delayed contrast-enhanced magnetic resonance Imaging to predict cardiacfunctional improvement after primary percutaneous coronary intervention for patients with acute myocardial infarction. Vietnamese Journal of Radiology and Nuclear Medicine, 37, 13-21. https://doi.org/10.55046/vjrnm.37.146.2020

Role of delayed contrast-enhanced magnetic resonance Imaging to predict cardiacfunctional improvement after primary percutaneous coronary intervention for patients with acute myocardial infarction

Dr Nguyen Khoi Viet1, A.Prof Vu Dang Luu2, A.Prof Nguyen Quoc Dung3
1 Bach Mai Hospital
2 Bach Mai hospital
3 Hội Điện quang và Y học hạt nhân Việt Nam

Main Article Content

Abstract

Objective: To access the transmural extent of hyperenhancement and infarct size at Delayed Contrast-Enhanced Magnetic Resonance Imaging
(DCE-MRI) on relating toleft ventricular (LV) functional improvement in reperfused myocardial infarction (MI) and to compare theLV morphology
and function on MRI afterprimary percutanous coronary revascularization.
Materialand Methods: Cine sequenceand Delayed ContrastEnhanced MRIwere underwent in period of 9 days after percutanous coronary revascularization on29 patients suffering fromAcute MI at Bach Mai Hospital. Long term follow-up cardiac MRI was done to compare the change in LV morphology and function, infarct size. Myocardial wall thickening and left ventricular volumes were quantified on cine-images, and the transmural extent of infarction (TEI), infarct size was doned on delayed-enhancement images. Remodeling was defined as an increase in LV end-diastolic volume index of 20% or higher at follow up.
Results: A decrease in myocardial mass (104,9 ± 23,4 to 96,1 ± 25,6 gram; p<0,05), mean SWT score (16,5 ± 4,9 to 14,6 ± 6,1; p<0,001) and increase the mean ejection fraction (45,7 ± 6,9 to 48,8 ± 9,2%; mean 3,2%; p<0,05), whereas mean end-diastolic volume(107,1 ± 23,8to131,7 ± 37,8 ml; p<0,0001) and mean end-systolic volume(58,5 ± 16,3 to 69,3 ± 29,3 ml, p<0,05) did not decrease. Segmental wall thickening did not change (42,6 ± 23,6to 43,3 ± 24,1%; p>0,5). The infarct size at DCE-MRI was related to LVEDVI (r=0,643, p<0,0001). Infarct size of 29% or more of LV area predicted remodeling with high sensitivity (100%) and specificity (89%). The extent of segments that was dysfunctional but viable was related to improvement in ejection fraction(r=0,56; p=0,002). Segmental
wall thickening improved significantly in segments with<25% TEI(35 ± 7 to48 ± 7%, p<0,0001), tended to improve in segments with 25% to 75% TEI (32± 10to38 ± 11%, p<0,001), whereas segments with>75% TEI did not improve (22 ± 15to20 ± 14%, p<0,05).


Conclusion:In patients with recent reperfused MI, functional improvement predicted by delayed contrast-enhanced Magnetic Resonance Imaging

Article Details

Keywords

Cardiac Magnetic Resonace Imaging, delayed enhancement MRI, late gadolinium, Acute myocardial infarction, transmural extent of infarction (TEI), infarct size.

References

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