Abstract
BackgroundAccurate assessment of myocardium at risk (MaR) after acute myocardial infarction (AMI) is necessary when assessing myocardial salvage. Contrast-enhanced steady-state free precession (CE-SSFP) is a recently developed cardiovascular magnetic resonance (CMR) method for assessment of MaR up to 1 week after AMI. Our aim was to validate CE-SSFP for determination of MaR in an experimental porcine model using myocardial perfusion single-photon emission computed tomography (MPS) as a reference standard and to test the stability of MaR-quantification over time after injecting gadolinium-based contrast.MethodsEleven pigs were subjected to either 35 or 40 min occlusion of the left anterior descending artery followed by six hours of reperfusion. A technetium-based perfusion tracer was administered intravenously ten minutes before reperfusion. In-vivo and ex-vivo CE-SSFP CMR was performed followed by ex-vivo MPS imaging. MaR was expressed as % of left ventricular mass (LVM).ResultsThere was good agreement between MaR by ex-vivo CMR and MaR by MPS (bias: 1 ± 3% LVM, r2 = 0.92, p < 0.001), between ex-vivo and in-vivo CMR (bias 0 ± 2% LVM, r2 = 0.94, p < 0.001) and between in-vivo CMR and MPS (bias -2 ± 3% LVM, r2 = 0.87, p < 0.001. No change in MaR was seen over the first 30 min after contrast injection (p = 0.95).ConclusionsContrast-enhanced SSFP cine CMR can be used to measure MaR, both in vivo and ex vivo, in a porcine model with good accuracy and precision over the first 30 min after contrast injection. This offers the option to use the less complex ex-vivo imaging when determining myocardial salvage in experimental studies.
Highlights
Accurate assessment of myocardium at risk (MaR) after acute myocardial infarction (AMI) is necessary when assessing myocardial salvage
Study population Twelve pigs were included in the study
A good correlation with a low bias was found between MaR by ex-vivo Contrast-enhanced steady-state free precession (CE-SSFP) (29 ± 9%) and myocardial perfusion single-photon emission computed tomography (MPS) (30 ± 9%) (n = 11, bias: 1 ± 3%, r2 = 0.92, p < 0.001, Fig. 2)
Summary
Accurate assessment of myocardium at risk (MaR) after acute myocardial infarction (AMI) is necessary when assessing myocardial salvage. Contrast-enhanced steady-state free precession (CE-SSFP) is a recently developed cardiovascular magnetic resonance (CMR) method for assessment of MaR up to 1 week after AMI. Our aim was to validate CE-SSFP for determination of MaR in an experimental porcine model using myocardial perfusion single-photon emission computed tomography (MPS) as a reference standard and to test the stability of MaR-quantification over time after injecting gadolinium-based contrast. Cardiovascular magnetic resonance (CMR) is considered the reference standard for determining infarct size in vivo using late gadolinium enhancement (LGE) imaging typically performed 15–20 min after contrast administration [2, 3]. CMR has been shown to enable assessment of MaR using T2-weighted (T2w) imaging which has been validated both in an experimental AMI model [4] and in patients up to 1 week after AMI [5]. T2w imaging performs inconsistently depending on vendor [6] and on the particular
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