Department of Radiology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, China.
Department of Cardiology, West China Hospital, Sichuan University, China.
Eur J Radiol. 2021 Apr;137:109590. doi: 10.1016/j.ejrad.2021.109590. Epub 2021 Feb 12.
Acutely infarcted native T1 (native T1) and extracellular volume (ECV) could quantify myocardial injury after acute myocardial infarction (AMI). Therefore, we sought to further explore their association with left ventricular (LV) remodeling during follow-up.
56 ST-segment-elevation MI patients were prospectively recruited and completed acute and 3-month cardiac magnetic resonance scans. T1 mapping, late gadolinium enhancement and cine imaging were performed to measure native T1, ECV, infarct size and LV global function, respectively. LV remodeling was evaluated as the change in LV end-diastolic volume index (△EDV) at follow-up scan compared with baseline.
In acute scan, 37 patients (66.07 %) had microvascular obstruction (MVO). The native T1 did not significantly differ between patients with or without MVO (1482.0 ± 80.6 ms vs. 1469.0 ± 71.6 ms, P = 0.541). However, ECV in patients without MVO was lower than that in patients with MVO (49.60 ± 8.57 % vs. 58.53 ± 8.62 %, P = 0.001). The native T1 only correlated with △EDV in patients without MVO (r = 0.495, P = 0.031); while ECV was associated with △EDV in all patients (r = 0.665, P = 0.002; r = 0.506, P = 0.001; r = 0.570, P < 0.001). Furthermore, ECV was independently associated with LV remodeling in multivariable linear regression analysis (β = 0.490, P = 0.002).
As a promising parameter for early risk stratification after AMI, ECV is associated with LV remodeling during follow-up; while native T1 may be feasible when MVO is absent.
急性梗死心肌的 T1 弛豫时间（native T1）和细胞外容积（ECV）可定量评估急性心肌梗死（AMI）后的心肌损伤。因此，我们旨在进一步探讨它们与 AMI 后随访期间左心室（LV）重构的相关性。
前瞻性纳入 56 例 ST 段抬高型心肌梗死患者，完成急性和 3 个月心脏磁共振扫描。分别进行 T1 mapping、钆延迟增强和电影成像以测量 native T1、ECV、梗死面积和 LV 整体功能。LV 重构通过与基线相比，在随访扫描时 LV 舒张末期容积指数（△EDV）的变化来评估。
在急性扫描中，37 例患者（66.07%）存在微血管阻塞（MVO）。有 MVO 和无 MVO 的患者 native T1 无显著差异（1482.0 ± 80.6 ms 比 1469.0 ± 71.6 ms，P = 0.541）。然而，无 MVO 的患者 ECV 低于有 MVO 的患者（49.60 ± 8.57% 比 58.53 ± 8.62%，P = 0.001）。仅在无 MVO 的患者中，native T1 与△EDV 相关（r = 0.495，P = 0.031）；而 ECV 与所有患者的△EDV 相关（r = 0.665，P = 0.002；r = 0.506，P = 0.001；r = 0.570，P < 0.001）。此外，在多变量线性回归分析中，ECV 与 LV 重构独立相关（β = 0.490，P = 0.002）。
作为 AMI 后早期危险分层的有前途的参数，ECV 与 AMI 后随访期间的 LV 重构相关；而当不存在 MVO 时，native T1 可能是可行的。
