Accuracy of Contrast-Enhanced Magnetic Resonance Imaging in Predicting Improvement of Regional Myocardial Function in Patients After Acute Myocardial Infarction
Why the study?
Does the absence of delayed hyperenhancement on contrast-enhanced MRI better predict improvement of regional myocardial function compared to the absence of early hypoenhancement in patients after acute myocardial infarction?
Population
Patients after acute myocardial infarction
Comparison
Contrast-enhanced MRI assessing delayed… vs Contrast-enhanced MRI assessing early…
Design
Cohort
Follow-up
7 months
Authors
Discussion
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Member takes
Implication
May aid post-MI risk stratification on contrast MRI; leaves open prospective validation before clinical adoption.
Key Points
- To determine the diagnostic accuracy of contrast-enhanced MRI patterns, specifically early hypoenhancement versus delayed hyperenhancement, in predicting quantitative improvement in regional myocardial contractility after acute myocardial infarction.
- Assessed 20 patients using contrast-enhanced and tagged MRI at 4 days and 7 months following acute myocardial infarction.
- Measured resting circumferential shortening strain (Ecc) across 24 segments per patient to evaluate initial dysfunction and long-term functional recovery.
- Dysfunctional segments with normal contrast enhancement exhibited significant strain recovery (from −4±7% to −12±7%, P<0.001), whereas segments with early hypoenhancement showed no significant improvement (from −2±6% to −6±9%, P=NS).
- Dysfunctional segments with delayed hyperenhancement had partial improvement (from −2±6% to −5±8%, P<0.001), which decreased as the transmural extent of hyperenhancement increased.
- Absence of delayed hyperenhancement demonstrated significantly higher sensitivity (82% vs 19%, P<0.001) and diagnostic accuracy (74% vs 49%, P<0.001) for predicting functional recovery compared with absence of early hypoenhancement.
Structured PICO
Does the absence of delayed hyperenhancement on contrast-enhanced MRI better predict improvement of regional myocardial function compared to the absence of early hypoenhancement in patients after acute myocardial infarction?
P
Population
Patients after acute myocardial infarction
I
Intervention
Contrast-enhanced MRI assessing delayed hyperenhancement
C
Comparator
Contrast-enhanced MRI assessing early hypoenhancement
O
Outcome
Improvement of regional contractility (resting circumferential shortening strain [Ecc])surrogate
The absence of delayed hyperenhancement on contrast-enhanced MRI is a significantly more accurate predictor of regional myocardial functional recovery after acute MI than the absence of early hypoenhancement.
Cite This Study
Gerber et al. (2002) studied this question.