Department of Cardiology, Dr. Nafiz Korez Sincan State Hospital, Fatih District, Gazi Mustafa Kemal Boulevard, Ankara, Turkey.
Department of Cardiology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.
Int J Cardiovasc Imaging. 2022 Feb;38(2):363-373. doi: 10.1007/s10554-021-02490-y. Epub 2021 Dec 13.
Tissue structure in the infarct and remote zone myocardium post-acute myocardial infarction (MI) may offer prognostic information concerning left ventricular remodeling. We aimed to identify or establish a relationship between adverse remodeling (AR) and changes (Δ) in T1, T2 mapping and extracellular volume (ECV) in post MI periods. Fifty-four MI patients underwent 3 Tesla CMR performed 2 weeks (acute phase) and 6 months post-MI. We measured T1 mapping with MOLLI sequences and T2 mapping with TrueFISP sequences. Hematocrit was quantified in scanning time. ECV was performed post-gadolinium enhancement. AR was defined as an increase of ≥ 10% in left ventricular end-diastolic volume in 6 months. In the acute phase post-MI, high T2 relaxation times of the infarct and remote zone myocardium were associated with AR (OR 1.15, p = 0.023 and OR 1.54, p = 0.002, respectively). There was a decrease in T2 relaxation times of the remote zone myocardium at 6 months in patients with AR (42.0 ± 4.0 vs. 39.0 ± 3.5 ms, p < 0.001), while insignificant difference was found in patients without AR. Increased ΔECV (%) and decreased remote ΔT2 values were associated with AR (OR 1.04, p = 0.043 and OR 0.77, p = 0.007, respectively). The diagnostic performance analysis in predicting AR showed that acute-phase remote T2 was similar to that of remote ΔT2 (p = 0.875) but was superior to that of ΔECV (%) (ΔAUC: 0.19 ± 0.09, p = 0.038). In both acute phase and change of 6 months post-MI, the T2 relaxation times in remote myocardium are independently associated with AR, and this suggests higher inflammation in the remote myocardium in the AR group than the other group, even though no significant pathophysiological difference was observed in the healing of the infarct zone between both groups.
急性心肌梗死后梗死区和远隔区心肌组织结构可提供有关左心室重构的预后信息。我们旨在确定或建立急性心肌梗死后（MI）不同时期不良重构（AR）与 T1、T2 映射和细胞外容积（ECV）变化（Δ）之间的关系。54 例 MI 患者在 2 周（急性期）和 MI 后 6 个月进行 3T CMR 检查。我们使用 MOLLI 序列测量 T1 映射，使用 TrueFISP 序列测量 T2 映射。在扫描时间内量化血细胞比容。在钆增强后进行 ECV。AR 定义为 6 个月时左心室舒张末期容积增加≥10%。在 MI 后急性期，梗死区和远隔区心肌的高 T2 弛豫时间与 AR 相关（OR 1.15，p=0.023 和 OR 1.54，p=0.002）。在 AR 患者中，6 个月时远隔区心肌的 T2 弛豫时间下降（42.0±4.0 与 39.0±3.5ms，p<0.001），而在无 AR 患者中则无显著差异。ΔECV（%）增加和远隔 ΔT2 值降低与 AR 相关（OR 1.04，p=0.043 和 OR 0.77，p=0.007）。在预测 AR 中的诊断性能分析表明，急性期远隔 T2 与远隔 ΔT2 相似（p=0.875），但优于 ΔECV（%）（ΔAUC：0.19±0.09，p=0.038）。在 MI 后急性期和 6 个月的变化中，远隔心肌的 T2 弛豫时间与 AR 独立相关，这表明 AR 组远隔心肌的炎症反应高于其他组，尽管两组梗死区的愈合无明显的病理生理差异。
