Cardiology Department, University Hospitals Leuven, Leuven, Belgium.
Eur Radiol. 2011 Apr;21(4):693-701. doi: 10.1007/s00330-010-1963-8. Epub 2010 Sep 25.
To describe the time course of myocardial infarct (MI) healing and left ventricular (LV) remodelling and to assess factors predicting LV remodelling using cardiac MRI.
In 58 successfully reperfused MI patients, MRI was performed at baseline, 4 months (4M), and 1 year (1Y) post MI RESULTS: Infarct size decreased between baseline and 4M (p < 0.001), but not at 1Y; i.e. 18 ± 11%, 12 ± 8%, 11 ± 6% of LV mass respectively; this was associated with LV mass reduction. Infarct and adjacent wall thinning was found at 4M, whereas significant remote wall thinning was measured at 1Y. LV end-diastolic and end-systolic volumes significantly increased at 1Y, p < 0.05 at 1Y vs. baseline and vs. 4M; this was associated with increased LV sphericity index. No regional or global LV functional improvement was found at follow-up. Baseline infarct size was the strongest predictor of adverse LV remodelling.
Infarct healing, with shrinkage of infarcted myocardium and wall thinning, occurs early post-MI as reflected by loss in LV mass and adjacent myocardial remodelling. Longer follow-up demonstrates ongoing remote myocardial and ventricular remodelling. Infarct size at baseline predicts long-term LV remodelling and represents an important parameter for tailoring future post-MI pharmacological therapies designed to prevent heart failure.
描述心肌梗死（MI）愈合和左心室（LV）重塑的时间过程，并使用心脏 MRI 评估预测 LV 重塑的因素。
在 58 例成功再灌注的 MI 患者中，在基线、4 个月（4M）和 1 年后（1Y）进行 MRI。
梗死面积在基线和 4M 之间减少（p<0.001），但在 1Y 时没有减少；即 LV 质量分别为 18±11%、12±8%、11±6%；这与 LV 质量减轻有关。在 4M 时发现梗死和相邻壁变薄，而在 1Y 时测量到明显的远程壁变薄。LV 舒张末期和收缩末期容积在 1Y 时显著增加，与基线和 4M 相比，在 1Y 时 p<0.05；这与 LV 球形指数增加有关。在随访中未发现局部或整体 LV 功能改善。基线梗死面积是不良 LV 重塑的最强预测因素。
梗死愈合，即梗死心肌和壁变薄的收缩，在 MI 后早期发生，反映在 LV 质量和相邻心肌重塑的丧失。更长时间的随访显示持续的远程心肌和心室重塑。基线时的梗死面积预测长期 LV 重塑，是为预防心力衰竭而设计的未来 MI 后药理学治疗量身定制的重要参数。
