BACKGROUND: The identification of viable myocardium in patients with impaired left ventricular contraction secondary to coronary heart disease is important clinically as such myocardium is likely to benefit from revascularisation. Blood oxygen level dependent (BOLD) magnetic resonance imaging (MRI) relies on changes in deoxyhaemoglobin concentration under stress for signal generation and could be used for the differentiation between scarred and viable myocardium. AIM: To assess the signal change on BOLD MRI in viable and scarred myocardium as identified by positron emission tomography (PET). METHOD: 19 patients with impaired left ventricular contraction and at least one akinetic area were enrolled. They underwent rest and dipyridamole stress MRI, using a double breath hold T2* weighted, ECG gated sequence to produce BOLD contrast images, and cine-MRI for wall thickening assessment. Dynamic perfusion and metabolic PET images followed the MRI. Signal change on BOLD MRI and the wall thickening were compared between rest and stress images in hibernating and scarred segments identified by PET on two short axis slices of mid ventricle, with eight segments each. RESULTS: Using PET, 68 segments were identified as hibernating and 42 as scarred. The hibernating segments were found on BOLD MRI to have an average signal change between rest and stress of -9.53%, compared with -2.15% in the scarred segments (p = 0.008). The average wall thickening was 8.7 mm in the hibernating segments compared with 5.9 mm in the scarred segments (p < 0.0001). CONCLUSIONS: BOLD MRI with wall thickening may differentiate scarred and viable myocardium and help identify suitable patients for revascularisation. Further larger studies are needed to establish a threshold for detection, sensitivity, and specificity.
BACKGROUND: The identification of viable myocardium in patients with impaired left ventricular contraction secondary to coronary heart disease is important clinically as such myocardium is likely to benefit from revascularisation. Blood oxygen level dependent (BOLD) magnetic resonance imaging (MRI) relies on changes in deoxyhaemoglobin concentration under stress for signal generation and could be used for the differentiation between scarred and viable myocardium. AIM: To assess the signal change on BOLD MRI in viable and scarred myocardium as identified by positron emission tomography (PET). METHOD: 19 patients with impaired left ventricular contraction and at least one akinetic area were enrolled. They underwent rest and dipyridamole stress MRI, using a double breath hold T2* weighted, ECG gated sequence to produce BOLD contrast images, and cine-MRI for wall thickening assessment. Dynamic perfusion and metabolic PET images followed the MRI. Signal change on BOLD MRI and the wall thickening were compared between rest and stress images in hibernating and scarred segments identified by PET on two short axis slices of mid ventricle, with eight segments each. RESULTS: Using PET, 68 segments were identified as hibernating and 42 as scarred. The hibernating segments were found on BOLD MRI to have an average signal change between rest and stress of -9.53%, compared with -2.15% in the scarred segments (p = 0.008). The average wall thickening was 8.7 mm in the hibernating segments compared with 5.9 mm in the scarred segments (p < 0.0001). CONCLUSIONS: BOLD MRI with wall thickening may differentiate scarred and viable myocardium and help identify suitable patients for revascularisation. Further larger studies are needed to establish a threshold for detection, sensitivity, and specificity.
Authors: R J Kim; E Wu; A Rafael; E L Chen; M A Parker; O Simonetti; F J Klocke; R O Bonow; R M Judd Journal: N Engl J Med Date: 2000-11-16 Impact factor: 91.245
Authors: Erica Dall'Armellina; Theodoros D Karamitsos; Stefan Neubauer; Robin P Choudhury Journal: Nat Rev Cardiol Date: 2010-09-21 Impact factor: 32.419
Authors: Jeffrey M Dendy; Sean G Hughes; Jonathan H Soslow; Daniel E Clark; Cynthia B Paschal; John C Gore Journal: Invest Radiol Date: 2022-04-13 Impact factor: 10.065
Authors: Ning Jin; Jie Deng; Tamuna Chadashvili; Yue Zhang; Yang Guo; Zhuoli Zhang; Guang-Yu Yang; Reed A Omary; Andrew C Larson Journal: Radiology Date: 2010-01 Impact factor: 11.105
Authors: Yong-Seok Han; Jun Hee Lee; Yeo Min Yoon; Chul Won Yun; Hyunjin Noh; Sang Hun Lee Journal: Cell Death Dis Date: 2016-10-06 Impact factor: 8.469
Authors: Jürgen E Schneider; Karen J Hulbert; Craig A Lygate; Michiel Ten Hove; Paul J Cassidy; Kieran Clarke; Stefan Neubauer Journal: MAGMA Date: 2004-11-08 Impact factor: 2.310
Authors: Susie Parnham; Jonathan M Gleadle; Sripal Bangalore; Suchi Grover; Rebecca Perry; Richard J Woodman; Carmine G De Pasquale; Joseph B Selvanayagam Journal: J Am Heart Assoc Date: 2015-08-10 Impact factor: 5.501