Layland, J. et al. (2017) Diagnostic accuracy of 3.0-T magnetic resonance T1 and T2 mapping and T2-weighted dark-blood imaging for the infarct-related coronary artery in Non-ST-segment elevation myocardial infarction. Journal of the American Heart Association, 6(4), e004759. (doi: 10.1161/JAHA.116.004759) (PMID:28364045) (PMCID:PMC5532996)
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Abstract
Background: Patients with recent non–ST‐segment elevation myocardial infarction commonly have heterogeneous characteristics that may be challenging to assess clinically. Methods and Results: We prospectively studied the diagnostic accuracy of 2 novel (T1, T2 mapping) and 1 established (T2‐weighted short tau inversion recovery [T2W‐STIR]) magnetic resonance imaging methods for imaging the ischemic area at risk and myocardial salvage in 73 patients with non–ST‐segment elevation myocardial infarction (mean age 57±10 years, 78% male) at 3.0‐T magnetic resonance imaging within 6.5±3.5 days of invasive management. The infarct‐related territory was identified independently using a combination of angiographic, ECG, and clinical findings. The presence and extent of infarction was assessed with late gadolinium enhancement imaging (gadobutrol, 0.1 mmol/kg). The extent of acutely injured myocardium was independently assessed with native T1, T2, and T2W‐STIR methods. The mean infarct size was 5.9±8.0% of left ventricular mass. The infarct zone T1 and T2 times were 1323±68 and 57±5 ms, respectively. The diagnostic accuracies of T1 and T2 mapping for identification of the infarct‐related artery were similar (P=0.125), and both were superior to T2W‐STIR (P<0.001). The extent of myocardial injury (percentage of left ventricular volume) estimated with T1 (15.8±10.6%) and T2 maps (16.0±11.8%) was similar (P=0.838) and moderately well correlated (r=0.82, P<0.001). Mean extent of acute injury estimated with T2W‐STIR (7.8±11.6%) was lower than that estimated with T1 (P<0.001) or T2 maps (P<0.001). Conclusions: In patients with non–ST‐segment elevation myocardial infarction, T1 and T2 magnetic resonance imaging mapping have higher diagnostic performance than T2W‐STIR for identifying the infarct‐related artery. Compared with conventional STIR, T1 and T2 maps have superior value to inform diagnosis and revascularization planning in non–ST‐segment elevation myocardial infarction. Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02073422.
| Item Type: | Articles |
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| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Mccomb, Dr Christie and Carrick, Dr David and Rauhalammi, Mr Samuli and Mangion, Dr Kenneth and Lee, Matthew and Oldroyd, Dr Keith and Layland, Dr Jamie and Berry, Professor Colin and McClure, Dr John and Radjenovic, Dr Aleksandra |
| Authors: | Layland, J., Rauhalammi, S., Lee, M. M.Y., Ahmed, N., Carberry, J., Teng Yue May, V., Watkins, S., McComb, C., Mangion, K., McClure, J. D., Carrick, D., O'Donnell, A., Sood, A., McEntegart, M., Oldroyd, K. G., Radjenovic, A., and Berry, C. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health |
| Journal Name: | Journal of the American Heart Association |
| Publisher: | Wiley |
| ISSN: | 2047-9980 |
| ISSN (Online): | 2047-9980 |
| Published Online: | 31 March 2017 |
| Copyright Holders: | Copyright © 2017 The Authors |
| First Published: | First published in Journal of the American Heart Association 6(4): e004759 |
| Publisher Policy: | Reproduced under a Creative Commons License |
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