Key result
CMR detects myocardial damage in cardiac arrest survivors with HCM or MI but misses coronary vasospasm.
Why the study?
The usefulness of CMR for identifying myocardial damage inducing out-of-hospital cardiac arrest may vary by medical institutions, patients' ages, and myocardial diseases.
Does cardiac magnetic resonance identify myocardial damage in survivors of out-of-hospital cardiac arrest?
Observational (n=19)
No
Does cardiac magnetic resonance identify myocardial damage in survivors of out-of-hospital cardiac arrest?
CMR is useful for identifying myocardial damage from hypertrophic cardiomyopathy or myocardial infarction in OHCA survivors and predicting post-ICD ventricular arrhythmias, but has limited utility for detecting coronary vasospasm.
CMR may miss vasospasm-related damage in OHCA survivors; hypothesis-generating and requires prospective validation before clinical use.
BACKGROUND: Cardiac magnetic resonance (CMR) has been reported to identify myocardial damage inducing out-of-hospital cardiac arrest (OHCA). However, the usefulness of CMR may be affected by the medical institutions, patients' ages, and myocardial diseases. AIM: To clarify the clinical usefulness and limitation of CMR for identifying myocardial damage in the survivors of OHCA in midtown. METHODS: Nineteen patients underwent CMR to detect myocardial damage related to OHCA in the midtown of a capital city. Cine, T1 and T2 mapping, T2-weighted, and late gadolinium enhancement (LGE) imaging were acquired using a 1.5 T scanner. We described the clinical characteristics of the survivors of OHCA and evaluated usefulness of CMR for identifying myocardial damage related to OHCA. RESULTS: Among 19 patients experiencing OHCA, 7 experienced it in trains or on railway platforms, 4 while practicing sports, and 4 during their daily work. Ten of the 19 survivors were diagnosed with coronary vasospasm (CVS), in whom CMR failed to depict its characteristic findings. CMR was useful for identifying myocardial damage associated with hypertrophic cardiomyopathy (HCM) or myocardial infarction (MI). LGE was related to serious ventricular arrhythmias after implantable cardioverter defibrillator (ICD) installation in 3 patients (CVS, 2; HCM, 1). CONCLUSION: CMR is useful for identifying myocardial damage of HCM or MI inducing OHCA and predicting ventricular arrhythmias after ICD implantation but has limited capability for detecting myocardial damage of CVS.
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Amano et al. (2025) conducted an observational in Out-of-hospital cardiac arrest (n=19). Cardiac magnetic resonance was evaluated on Identification of myocardial damage. Cardiac magnetic resonance identified myocardial damage in cardiac arrest survivors with hypertrophic cardiomyopathy or myocardial infarction, but failed to detect damage from coronary vasospasm.
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