Alexander Stork MD, Presenter: Nothing to Disclose

Gunnar Lund MD, Abstract Co-Author: Nothing to Disclose

Martin Bansmann MD, Abstract Co-Author: Nothing to Disclose

Kai Muellerleile, Abstract Co-Author: Nothing to Disclose

Joern K. Kemper MD, Abstract Co-Author: Nothing to Disclose

Gerhard B. Adam MD, Abstract Co-Author: Nothing to Disclose

The purpose of the current study was to analyze which clinical or MRI parameter predicts best the occurrence of left-ventricular (LV) remodeling in patients after reperfused acute myocardial infarction (AMI).

CE- and Cine-MRI were performed in 55 patients (age: 56 ±13 years) with first reperfused AMI (CK max: 2415 ±2098 U/L) at baseline (5.0 ±3.3 days after AMI) and at follow-up (8.0 ±2.7 months after AMI) using a 1.5 T scanner. Infarct size was measured 10 min after injection of 0.1 mmol/kg Gd-DTPA using a T1-weighted TurboFLASH inversion recovery sequence. Infarct size was calculated as % of LV area using a threshold method including only that enhanced myocardium with a signal intensity > +2.0 SD of remote normal myocardium. LV ejection fraction, mass and volumes were quantified at baseline and follow-up using Cine-MRI. Remodeling was defined as an increase in LV end-diastolic volume index (LVEDVI) by >20% compared to baseline.

LV ejection fraction improved from baseline to follow-up from 52 ±11% to 55 ± 10% (P24% of LV area at baseline predicted LV remodeling with high sensitivity (92%), specificity (93%) and diagnostic accuracy (93%).

After reperfused AMI, the degree of LV remodeling is directly related to the infarct size at baseline. An infarct size >24% of LV area discriminates patients who are at high risk for LV remodeling from those who maintain normal LV dimensions.

The knowledge of predictiors of remodeling after AMI could help in the risk stratification of patients and thus could be valuable in treatment optimization.

Stork, A, Lund, G, Bansmann, M, Muellerleile, K, Kemper, J, Adam, G, Prediction of Left Ventricular Remodeling by Infarct Size Obtained by Contrast-enhanced MRI in Patients with Reperfused Acute Myocardial Infarction.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4441604.html