Key result
Increased remote myocardial T2 post-MI is strongly linked to LV remodeling.
Why the study?
Pathophysiological changes in the remote myocardium after acute MI remain less understood, prompting assessment of remote myocardial inflammation and its link to LV remodeling using T2 mapping.
Does T2 mapping identify inflammation in remote myocardium post-MI and correlate with LV remodeling?
Observational (n=85)
Does T2 mapping identify inflammation in remote myocardium post-MI and correlate with LV remodeling?
T2 mapping can detect inflammation in remote myocardium post-MI, and variations in remote T2 are independently associated with left ventricular remodeling.
Remote T2 mapping may flag post-MI inflammation tied to remodeling risk; hypothesis-generating and needs prospective validation before clinical use.
BACKGROUND: The pathophysiological changes in the remote myocardium after acute myocardial infarction (MI) remains less understood. PURPOSE: To assess the inflammation in the remote myocardium post-MI and its association with left ventricular (LV) remodeling using T2 mapping. STUDY TYPE: Prospective. ANIMAL MODEL AND SUBJECTS: Twelve pigs at 3-day post-MI, 6 pigs at 3-month post-MI, 6 healthy pigs; 54 patients at 3-day and 3-month post-MI, 31 healthy volunteers; FIELD STRENGTH/SEQUENCE: A 3 T MRI/ steady-state free-precession sequence for T2 mapping (animals: 0, 30, and 55 msec; human: 0, 25, and 55 msec), phase-sensitive inversion recovery gradient echo for late gadolinium enhancement (LGE), balanced steady free-precession sequence for cine. ASSESSMENT: Infarcted myocardium was defined on LGE, remote T2 was measured on T2 maps. LV remodeling was evaluated as LV end-diastolic volume change index between two scans using cine. CD68 staining was conducted to detect monocyte/macrophage. STATISTICAL TESTS: Student-t test and one-way ANOVA were used to compare remote T2 with normal controls. The association of remote T2 with LV remodeling was assessed using linear regression. P values of <0.05 were used to denote statistical significance. RESULTS: Compared with healthy pigs, remote T2 significantly increased from 3 days to 3 months post-MI (31.43 ± 0.67 vs. 33.53 ± 1.15 vs. 36.43 ± 1.07 msec). CD68 staining demonstrated the inflammation in remote myocardium post-MI but not in healthy pigs. Significant remote myocardial alterations in T2 were also observed in human group (40.51 ± 1.79 vs. 41.94 ± 1.14 vs. 42.52 ± 1.71 msec). In patients, the 3-month remote T2 (β = 0.432) and remote T2 variation between two scans (β = 0.554) were both independently associated with LV remodeling. CONCLUSION: T2 mapping could characterize the abnormalities in the remote myocardium post-MI, which was potentially caused by the inflammatory response. Moreover, variations in remote T2 were associated with LV remodeling. EVIDENCE LEVEL: 1 TECHNICAL EFFICACY: Stage 3.
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Yang et al. (2021) conducted an observational in Acute Myocardial Infarction (n=85). T2 mapping MRI vs. Healthy volunteers was evaluated on Remote T2 values and association with left ventricular remodeling (β = 0.554). T2 mapping revealed that remote myocardial T2 values significantly increased post-MI and were independently associated with left ventricular remodeling (β = 0.554).
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