Tissue Cardiovascular Magnetic Resonance Demonstrates Regional Diastolic Dysfunction in Remote Tissue Early After Inferior Myocardial Infarction

Abstract

To investigate regional diastolic and systolic function using tissue cardiovascular magnetic resonance (CMR), early after transmural myocardial infarction of the inferior wall due to single proximal right coronary artery disease. Velocity encoded CMR was used to measure early diastolic transmitral flow velocity (E), and regional, longitudinal, myocardial systolic (Sa) and early diastolic (Ea) velocities (tissue CMR) in 15 patients with a recent transmural inferior myocardial infarction and in 15 age and LV-mass index matched control subjects. An unpaired two-tailed t test was used to assess significance of continuous variables. Global systolic (ejection fraction 46 +/- 7% versus 57 +/- 4%, p = 0.000052) and global diastolic LV function (average Ea of infarcted or inferior, remote or anterior, adjacent or septal and lateral myocardium 6.8 +/- 1.7 cm/s versus 10.4 +/- 1.5 cm/s, p = 0.0000012) were impaired in patients as compared to controls. Regional systolic and diastolic LV velocities were impaired in infarcted and adjacent tissue in patients. However, in remote or anterior tissue, systolic velocities were preserved (Sa 6.6 +/- 2.0 cm/s versus 6.8 +/- 1.4 cm/s, p = 0.70), but diastolic velocities were impaired in patients as compared to controls (Ea 7.2 +/- 2.3 cm/s versus 10.2 +/- 2.5 cm/s, p = 0.0026). Regional diastolic velocities early after inferior myocardial infarction are impaired in the infarcted, adjacent and remote tissue, but regional systolic velocities are preserved in remote tissue.