What is the clinical evidence from this study?

Study design: Observational. Population: Acute Myocardial Infarction (n=29). Intervention: Gd-DTPA-enhanced MRI. Primary outcome: Myocardial functional recovery (improvement of anterior wall motion).

January 1, 1999Open Access

Gadolinium-DTPA-Enhanced Magnetic Resonance Imaging and Functional Outcome in Patients With Acute Myocardial Infarction

Q: What does this research mean for the field?

Gadolinium-DTPA-enhanced MRI patterns in acute myocardial infarction reflect injury severity, with non-enhancement predicting improved anterior wall motion, higher TIMI flow, and lower peak creatine kinase at one month. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Key Result

Gd-DTPA-enhanced MRI patterns in acute MI reflect injury severity, with non-enhancement predicting improved anterior wall motion, higher TIMI flow, and lower peak CK at 1 month.

Study Design

Type

Observational (n=29)

Structured PICO

Does Gadolinium-DTPA-enhanced MRI predict myocardial functional recovery in patients with acute myocardial infarction?

Population

29 patients with their first acute myocardial infarction

Intervention

Gadolinium-DTPA-enhanced magnetic resonance imaging (MRI) performed in the first week (4.2+/-0.3 days) and at 1 month after onset

Outcome

Myocardial functional recovery (improvement of anterior wall motion) at 1 monthsurrogate

Gd-DTPA-enhanced MRI patterns closely reflect the severity of myocardial injury and are useful in predicting functional recovery after acute MI.

Abstract

This study was designed to test the hypothesis that Gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA)-enhanced magnetic resonance images (MRI) reflect the severity of ischemic injury during the acute and chronic phases of myocardial infarction (MI). Twenty-nine patients with their first acute MI underwent Gd-DTPA-enhanced MRI in the first week (4.2+/-0.3 days) and at 1 month after onset. Pairs of left ventriculograms were compared with Gd-DTPA-enhanced magnetic resonance images, classified into 3 pattern groups: hyper-enhancement, with and without a central hypo-enhanced region (P1 and P2, respectively), and non-enhancement (P3). In the acute phase of MI, P1 was found in 10, P2 in 11, and P3 in 8 patients. One month later, the image pattern had changed from P1 to P2 in a single patient, from P2 to P3 in 4 patients, and had remained identical in the others. Patients with P3 showed improvement of anterior wall motion in the 1-month follow-up study, and had higher TIMI flow grades and lower peak creatine kinase values than those without recovery. Thus, Gd-DTPA-enhanced magnetic resonance images, closely reflecting the severity of myocardial injury, are useful in predicting myocardial functional recovery after MI.

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