Key result
In patients with reperfused acute myocardial infarction, native T1 of remote myocardium significantly decreased from 1002 ms at baseline to 985 ms at 3 months, suggesting resolution of remote edema.
Observational (n=42)
No
In patients with reperfused first-time AMI, native T1 of remote myocardium decreases over 3 months, while persistently elevated remote extracellular volume is associated with left ventricular dilatation.
Remote T1 decline may mark resolving edema post-reperfused AMI; leaves open whether serial mapping predicts LV remodeling.
OBJECTIVES: To characterize the temporal alterations in native T1 and extracellular volume (ECV) of remote myocardium after acute myocardial infarction (AMI), and to explore their relation to left ventricular (LV) remodeling. METHODS: Forty-two patients with AMI successfully treated with primary PCI underwent cardiovascular magnetic resonance after 4-6 days and 3 months. Cine imaging, late gadolinium enhancement, and T1-mapping (MOLLI) was performed at 1.5T. T1 values were measured in the myocardial tissue opposite of the infarct area. Myocardial ECV was calculated from native- and post-contrast T1 values in 35 patients, using a correction for synthetic hematocrit. RESULTS: Native T1 of remote myocardium significantly decreased between baseline and follow-up (1002 ± 39 to 985 ± 30ms, p<0.01). High remote native T1 at baseline was independently associated with a high C-reactive protein level (standardized Beta 0.32, p = 0.04) and the presence of microvascular injury (standardized Beta 0.34, p = 0.03). ECV of remote myocardium significantly decreased over time in patients with no LV dilatation (29 ± 3.8 to 27 ± 2.3%, p<0.01). In patients with LV dilatation, remote ECV remained similar over time, and was significantly higher at follow-up compared to patients without LV dilatation (30 ± 2.0 versus 27 ± 2.3%, p = 0.03). CONCLUSIONS: In reperfused first-time AMI patients, native T1 of remote myocardium decreased from baseline to follow-up. ECV of remote myocardium decreased over time in patients with no LV dilatation, but remained elevated at follow-up in those who developed LV dilatation. Findings from this study may add to an increased understanding of the pathophysiological mechanisms of cardiac remodeling after AMI.
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Biesbroek et al. (2017) conducted an observational in Acute Myocardial Infarction (n=42). Time after acute myocardial infarction vs. Baseline (4-6 days post-AMI) was evaluated on Native T1 of remote myocardium (p=<0.01). In patients with reperfused acute myocardial infarction, native T1 of remote myocardium significantly decreased from 1002 ms at baseline to 985 ms at 3 months, suggesting resolution of remote edema.
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