The role of cardiac magnetic resonance non-contrast T1 mapping in differentiation between injured and salvaged myocardium in acute and chronic myocardial infarction

Q: What are the key findings of this study?

Native T1 mapping values in the infarct area were significantly higher in acute STEMI than at 6-month follow-up (1564.1 vs. 1384.8 ms, p<0.0001) and distinguished peri-infarct from remote tissue.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Acute and chronic ST-segment elevation myocardial infarction (STEMI) (n=30). Intervention: 3T cardiac magnetic resonance non-contrast native T1 mapping (MOLLI sequence) in acute vs. chronic stages vs. Chronic stage at 6-month follow-up (and comparison across infarct, no-reflow, peri-infarct, and remote myocardium referenced to late gadolinium enhancement). Primary outcome: Native T1 mapping relaxation time in the infarct area between baseline (acute stage) and 6-month follow-up (chronic stage) (MD 179.3, p=< 0.0001).

Q: What does this research mean for the field?

Cardiac magnetic resonance non-contrast native T1 mapping quantitatively differentiates injured from salvaged myocardium, with significantly higher T1 values in acute infarct core compared to 6-month follow-up. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Małgorzata Urbańczyk‐Zawadzka; Robert Banyś; Ewa Kwiecień; Maciej Krupiński

doi:10.5114/aic.2022.121032

January 1, 2022Advances in Interventional CardiologyOpen Access

The role of cardiac magnetic resonance non-contrast T1 mapping in differentiation between injured and salvaged myocardium in acute and chronic myocardial infarction

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Key result

Infarct native T1 values drop by ~179 ms from acute STEMI to 6-month follow-up.

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Why the study?

Does non-contrast native T1 mapping on 3T cardiac magnetic resonance differentiate between injured (infarct core, microvascular obstruction) and salvaged (peri-infarct, remote) myocardium in acute and chronic stages of STEMI?

Key Points

To quantitatively evaluate cardiac magnetic resonance non-contrast T1 mapping values to differentiate between injured and salvaged myocardium in acute and chronic myocardial infarction stages.
Evaluated 30 consecutive patients with acute ST-segment elevation myocardial infarction using 3T cardiac magnetic resonance imaging at baseline and follow-up (mean interval: 189 ±11.6 days).
Acquired native T1 maps using the Modified Look-Locker Inversion-Recovery (MOLLI) sequence without contrast and compared them to late gadolinium enhancement images.
Quantitatively measured T1 mapping values across four distinct tissue regions: infarct core, no-reflow area, peri-infarct zone, and remote myocardium.
Infarct core T1 values were significantly higher at baseline than at follow-up (1564.1 ±146.5 vs. 1384.8 ±79.1; p < 0.0001), whereas no-reflow areas showed lower baseline values (1200.3 ±246.2 vs. 1332.8 ±138.5; p = 0.0291).
Differences between the peri-infarct zone and remote myocardium were statistically significant at baseline (difference: 50.0 ±69.8; p = 0.0008) and remained significant at follow-up (difference: 53.7 ±89.1; p = 0.002).
Comparing baseline to follow-up, T1 mapping values did not show significant differences in the peri-infarct area (1257.4 ±56.1 vs. 1230.6 ±69.9; p = 0.0933) or remote myocardium (1209.5 ±76.3 vs. 1176.0 ±94.4; p = 0.0505).

Study Design

Type

Cohort (n=30)

Structured PICO

Does non-contrast native T1 mapping on 3T cardiac magnetic resonance differentiate between injured (infarct core, microvascular obstruction) and salvaged (peri-infarct, remote) myocardium in acute and chronic stages of STEMI?

P

Population

30 consecutive patients (mean age 68.7 years) with acute STEMI evaluated by 3T cardiac magnetic resonance at baseline and at 6-month (mean 189 days) follow-up.

E

Exposure

3T cardiac magnetic resonance (CMR) native non-contrast T1 mapping using the Modified Look-Locker Inversion-Recovery (MOLLI) sequence in acute and chronic (mean 189 ±11.6 days) stages of myocardial infarction.

C

Comparator

Late gadolinium enhancement (LGE) images obtained 10–15 min after administration of 0.1 mmol/kg gadolinium-based contrast agent, and within-patient comparison between acute baseline and 6-month chronic follow-up across infarct core, no-reflow (MVO), peri-infarct, and remote myocardium.

O

Outcome

Quantitative native T1 mapping values in the infarct area, no-reflow area, peri-infarct area, and remote myocardium at baseline (acute MI) and at 6-month follow-up (chronic MI).surrogate

Main Result

Mean Difference: 179.3

Absolute Event Rate: 1564.1% vs 1384.8%

p-value: p=< 0.0001

Non-contrast CMR native T1 mapping quantitatively differentiates infarct core, microvascular obstruction, peri-infarct, and remote myocardium across acute and chronic STEMI without requiring gadolinium contrast.

Limitations

Extracellular volume (ECV) and T2 mapping analyses were not performed
Did not perform extracellular volume (ECV) and T2 mapping analysis

Implication

Supports gadolinium-free tissue differentiation in STEMI; leaves open clinical adoption pending prospective validation.

Abstract

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Urbańczyk-Zawadzka M, Banyś R, Kwiecień E, Krupiński M. The role of cardiac magnetic resonance non-contrast T1 mapping in differentiation between injured and salvaged myocardium in acute and chronic myocardial infarction. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2022. doi:10.5114/aic.2022.121032. APA Urbańczyk-Zawadzka, M., Banyś, R., Kwiecień, E., & Krupiński, M. (2022). The role of cardiac magnetic resonance non-contrast T1 mapping in differentiation between injured and salvaged myocardium in acute and chronic myocardial infarction. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. https://doi.org/10.5114/aic.2022.121032 Chicago Urbańczyk-Zawadzka, Małgorzata, Robert Banyś, Ewa Kwiecień, and Maciej Krupiński. 2022. "The role of cardiac magnetic resonance non-contrast T1 mapping in differentiation between injured and salvaged myocardium in acute and chronic myocardial infarction". Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. doi:10.5114/aic.2022.121032. Harvard Urbańczyk-Zawadzka, M., Banyś, R., Kwiecień, E., and Krupiński, M. (2022). The role of cardiac magnetic resonance non-contrast T1 mapping in differentiation between injured and salvaged myocardium in acute and chronic myocardial infarction. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. https://doi.org/10.5114/aic.2022.121032 MLA Urbańczyk-Zawadzka, Małgorzata et al. "The role of cardiac magnetic resonance non-contrast T1 mapping in differentiation between injured and salvaged myocardium in acute and chronic myocardial infarction." Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 2022. doi:10.5114/aic.2022.121032. Vancouver Urbańczyk-Zawadzka M, Banyś R, Kwiecień E, Krupiński M. The role of cardiac magnetic resonance non-contrast T1 mapping in differentiation between injured and salvaged myocardium in acute and chronic myocardial infarction. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2022. doi:10.5114/aic.2022.121032.

Discussion

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Cite This Study

Urbańczyk‐Zawadzka et al. (2022) conducted a cohort in Acute and chronic ST-segment elevation myocardial infarction (STEMI) (n=30). 3T cardiac magnetic resonance non-contrast native T1 mapping (MOLLI sequence) in acute vs. chronic stages vs. Chronic stage at 6-month follow-up (and comparison across infarct, no-reflow, peri-infarct, and remote myocardium referenced to late gadolinium enhancement) was evaluated on Native T1 mapping relaxation time in the infarct area between baseline (acute stage) and 6-month follow-up (chronic stage) (MD 179.3, p=< 0.0001). Native T1 mapping values in the infarct area were significantly higher in acute STEMI than at 6-month follow-up (1564.1 vs. 1384.8 ms, p<0.0001) and distinguished peri-infarct from remote tissue.

synapsesocial.com/papers/6a734ebb0c0db29dfc2c24fa https://doi.org/10.5114/aic.2022.121032

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The role of cardiac magnetic resonance non-contrast T1 mapping in differentiation between injured and salvaged myocardium in acute and chronic myocardial infarction

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

The role of cardiac magnetic resonance non-contrast T1 mapping in differentiation between injured and salvaged myocardium in acute and chronic myocardial infarction

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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