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• W2317031799 abstract "In patients with acute myocardial infarction (AMI) the myocardial salvage index (MSI) quantified by Cardiovascular Magnetic Resonance (CMR) is defined as the proportion of myocardial edema without infarction, derived from Late Gadolinium Enhancement (LGE), within the myocardial area at risk (MAR), as defined by the area of edema. While after a coronary occlusion time of more than 8 hours, relevant myocardial salvage is highly unlikely, previous data, however, showed evidence for myocardial edema surrounding the infarcted tissue even more than 6 hours after onset of symptoms. We therefore speculated that peri-infarct edema in the setting of very late reperfused MI is a consistent finding and thus not be related to salvage. In 6 tertiary hospitals, 74 patients who underwent PCI between 8 to 24 hours after presentation with AMI were included in the study. The time to reperfusion (TTR) was correlated with the infarct size (IS), extent of myocardial edema and MSI. T2-weighted and LGE images were used to characterize the extent of myocardial edema, infarction and the apparent myocardial salvage index. A stratified analysis was conducted considering subjects divided in four quartiles of TTR. The mean TTR was 696±231 minutes. The edematous area was consistently larger than the infarct (mean difference 10± 8.4%) and the apparent myocardial salvage index was 31±20%. There was a strong correlation between the area of infarction and the extent of myocardial edema (r=0.84, p<0.0001). TTR did not show significant correlation with the infarct area (p=0.21), the extent of myocardial edema (p=0.084), microvascular obstruction (p=0.78) and salvage index (p=0.93) on the entire population and between the 4 groups. In patients with more than 8 hours ischemia time, we consistently demonstrated myocardial edema surrounding the infarcted tissue. Its extent did not vary significantly between quartiles of different times to reperfusion. These data therefore indicate that, in late reperfused AMI, peri-infarct edema may not be related to myocardial salvage, but may represent peri-infarct injury secondary to reperfusion. These findings have significant implications for the quantification of myocardial salvage by CMR in patients with late refused AMI." @default.
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• W2317031799 date "2012-09-01" @default.
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• W2317031799 title "475 Does All Myocardial Edema as Observed in Cardiovascular Magnetic Resonance Represent Myocardial Salvage?" @default.
• W2317031799 doi "https://doi.org/10.1016/j.cjca.2012.07.436" @default.
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