Peri-infarct edema leads to overestimation of myocardial salvage in late reperfused myocardial infarction

Iacopo Carbone,Ingo Eitel,Marco Francone,Jan Bogaert,Sven Plein,Matthias G Friedrich,Pier Giorgio Masci,Peter Bernhardt

doi:10.1186/1532-429x-15-s1-p209

Iacopo Carbone, Ingo Eitel + Show 6 more

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https://doi.org/10.1186/1532-429x-15-s1-p209

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Abstract

Background In patients with acute myocardial infarction (AMI) the myocardial salvage index (MSI) quantified by Cardiovascular Magnetic Resonance (CMR) is defined as the volumetric difference of myocardial edema, reflecting the perfusion bed, and the infarcted tissue. While after a coronary occlusion time of more than 8 hours, relevant myocardial salvage is highly unlikely, previous data however showed myocardial edema surrounding the infarcted tissue after prolonged occlusion times. We therefore speculated that peri-infarct edema can be consistently observed in very late reperfused MI, indicating that edema in late reperfused MI does not necessarily reflect myocardial salvage.

Highlights

In patients with acute myocardial infarction (AMI) the myocardial salvage index (MSI) quantified by Cardiovascular Magnetic Resonance (CMR) is defined as the volumetric difference of myocardial edema, reflecting the perfusion bed, and the infarcted tissue.While after a coronary occlusion time of more than 8 hours, relevant myocardial salvage is highly unlikely, previous data showed myocardial edema surrounding the infarcted tissue after prolonged occlusion times
Peri-infarct edema leads to overestimation of myocardial salvage in late reperfused myocardial infarction
Standard CMR protocols were used to characterize the extent of myocardial edema, infarction, microvscular obstruction (MO) and the apparent myocardial salvage index

Summary

Introduction

In patients with acute myocardial infarction (AMI) the myocardial salvage index (MSI) quantified by Cardiovascular Magnetic Resonance (CMR) is defined as the volumetric difference of myocardial edema, reflecting the perfusion bed, and the infarcted tissue. While after a coronary occlusion time of more than 8 hours, relevant myocardial salvage is highly unlikely, previous data showed myocardial edema surrounding the infarcted tissue after prolonged occlusion times. We speculated that peri-infarct edema can be consistently observed in very late reperfused MI, indicating that edema in late reperfused MI does not necessarily reflect myocardial salvage

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Conclusion