Department of Internal Medicine I, Center of Cardiovascular Medicine, University Hospital Würzburg, Oberdürrbacher-Str. 6, 97080, Würzburg, Germany.
MAGMA. 2011 Oct;24(5):277-84. doi: 10.1007/s10334-011-0262-y. Epub 2011 Jun 14.
To analyze the remodeling processes of the infarct territory in the time course of infarct healing.
Serial late enhancement (LE) studies were performed in 30 patients following reperfused myocardial infarction (MI) in the first and second week post-MI and after 3 months. To characterize infarct remodeling over time, the following variables were derived and analyzed in a blinded fashion: Infarct size (IS, in mm(3)), maximum infarct thickness (IT(max), mm), mean infarct thickness (IT(mean), mm) and the variability of infarct thickness (VIT=IT(max)/IT(mean)). Further, a new parameter for the assessment of infarct remodeling, the infarct extent (IE, mm(2)) was computed. IE quantifies IS in two dimensions along the heart's circumferential and longitudinal directions. IS was divided by the IE to obtain IT(mean).
Overall infarct thickness was highly variable. Infarct shrinkage due to infarct thinning and IE reduction was found in the first months of healing. IS, IT(mean) and IT(max) significantly decreased during follow-up. There was a less consistent change of the IE: IE decreased in 75% of all infarcts from the first week up to 3 months post-MI, whereas 25% of infarcts expanded. Infarct thinning was found in almost all patients (92%), hence occurring in patients with infarct expansion and in patients without infarct expansion.
Infarct thinning and-to a lesser extent-IE reduction, contribute to infarct shrinkage in the time course of infarct healing. Infarct thinning may occur without infarct expansion.
分析梗死愈合过程中梗死灶的重构过程。
对 30 例再灌注心肌梗死后 1 周和 2 周及 3 个月的患者进行了连续晚期增强（LE）研究。为了描述随时间的梗死重构，我们以盲法的方式对以下变量进行了推导和分析：梗死面积（IS，mm3）、最大梗死厚度（IT(max)，mm）、平均梗死厚度（IT(mean)，mm）和梗死厚度变异性（VIT=IT(max)/IT(mean)）。此外，还计算了一个评估梗死重构的新参数，即梗死范围（IE，mm2）。IE 沿心脏的圆周和长轴方向量化 IS 的二维情况。IS 除以 IE 可获得 IT(mean)。
整体梗死厚度的变化较大。在愈合的头几个月，我们发现由于梗死变薄和 IE 减少导致梗死缩小。在随访过程中，IS、IT(mean)和 IT(max)显著降低。IE 的变化并不一致：75%的梗死在第一周至 3 个月时 IE 减少，而 25%的梗死扩张。几乎所有患者（92%）都出现了梗死变薄，因此，梗死变薄发生在梗死扩张的患者和没有梗死扩张的患者中。
在梗死愈合过程中，梗死变薄和（程度较轻的）IE 减少导致梗死缩小。梗死变薄可能发生在没有梗死扩张的情况下。
