Key result
Myocardial infarction reduces pulmonary blood volume variation ~30%, revealing a potential noninvasive MR heart failure marker.
Why the study?
The usefulness of MR imaging for estimating pulmonary blood volume and its variation during the cardiac cycle in experimental heart failure was evaluated.
Does MRI-measured pulmonary blood volume variation decrease after myocardial infarction in a pig model?
Does MRI-measured pulmonary blood volume variation decrease after myocardial infarction in a pig model?
Absolute Event Rate: 43% vs 61%
p-value: p=0.04
MR imaging can noninvasively assess the variation of pulmonary blood volume during the cardiac cycle, which decreases following myocardial infarction and may serve as a marker of heart failure.
Pulmonary blood volume variation merits preclinical exploration as an MR heart failure marker; leaves open human validation before any clinical consideration.
PURPOSE: To prospectively evaluate the usefulness of magnetic resonance (MR) imaging for estimating pulmonary blood volume (PBV) and the variation in PBV throughout the cardiac cycle in experimental heart failure. MATERIALS AND METHODS: The animal care committee approved this prospective study. Seven pigs were studied before and after myocardial infarction. PBV measurement was validated in a phantom and calculated as the product of cardiac output determined with velocity-encoded MR imaging and the pulmonary transit time for an intravenous bolus of contrast material to pass through the pulmonary circulation. The difference in arterial and venous pulmonary flow during the cardiac cycle was integrated for calculation of the PBV variation (expressed as percentage of stroke volume). Differences were evaluated with the Wilcoxon test. RESULTS: Calculated and direct phantom measurements of PBV differed by a mean of 4% +/- 3 (standard deviation) (R(2) = 0.97, P < .001). Infarction induced a decrease in left ventricular stroke volume (44 mL +/- 6 vs 27 mL +/- 7; P = .02), ejection fraction (55% +/- 5 vs 41% +/- 4; P = .02), and PBV variation (61% +/- 12 vs 43% +/- 15; P = .04) but not PBV (225 mL +/- 23 vs 211 mL +/- 42; P = .50). The mean pulmonary artery pressure increased after infarction (19 mm Hg +/- 6 vs 27 mm Hg +/- 4; P = .04). CONCLUSION: Following infarction, the PBV variation but not PBV decreased. PBV variation was the noninvasive measure exhibiting the greatest percentage of change following infarction. MR imaging can be used to assess the variation of the PBV during the cardiac cycle as a marker of heart failure.
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Ugander et al. (2010) studied Myocardial infarction and heart failure (n=7). Myocardial infarction vs. Baseline (before infarction) was evaluated on Pulmonary blood volume (PBV) variation (p=0.04). Myocardial infarction significantly decreased pulmonary blood volume variation from 61% to 43% (P=0.04), demonstrating its potential as a noninvasive MR imaging marker of heart failure.
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