Leticia Fernández-Friera1, José Manuel García-Ruiz2, Ana García-Álvarez3, Rodrigo Fernández-Jiménez4, Javier Sánchez-González5, Xavier Rossello6, Sandra Gómez-Talavera7, Gonzalo J López-Martín8, Gonzalo Pizarro9, Valentín Fuster10, Borja Ibáñez11. 1. Área de Fisiopatología Vascular, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; Unidad de Imagen Cardiaca Avanzada, Departamento de Cardiología, Hospital Universitario HM Montepríncipe, Madrid, Spain. 2. Área de Fisiopatología del Miocardio, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; Departamento de Cardiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain. 3. Área de Fisiopatología del Miocardio, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; Unidad de Insuficiencia Cardiaca, Departamento de Cardiología, Hospital Clínic, Barcelona, Spain. 4. Área de Fisiopatología del Miocardio, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; Departamento de Cardiología, Hospital Clínico San Carlos, Madrid, Spain. 5. Área de Fisiopatología del Miocardio, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; Departamento de Ciencia Clínica, Philips Healthcare Iberia, Madrid, Spain. 6. Área de Fisiopatología del Miocardio, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; The Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom. 7. Área de Fisiopatología del Miocardio, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; Servicio de Cardiología, IIS-Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain. 8. Área de Fisiopatología del Miocardio, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain. 9. Área de Fisiopatología Vascular, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; Departamento de Cardiología, Complejo Hospitalario Ruber Juan Bravo, Universidad Europea de Madrid (UEM), Madrid, Spain. 10. Área de Fisiopatología Vascular, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; Department of Cardiology, Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai School of Medicine, New York, United States. 11. Área de Fisiopatología Vascular, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; Servicio de Cardiología, IIS-Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain. Electronic address: bibanez@cnic.es.
Abstract
INTRODUCTION AND OBJECTIVES: Area at risk (AAR) quantification is important to evaluate the efficacy of cardioprotective therapies. However, postinfarction AAR assessment could be influenced by the infarcted coronary territory. Our aim was to determine the accuracy of T2-weighted short tau triple-inversion recovery (T2W-STIR) cardiac magnetic resonance (CMR) imaging for accurate AAR quantification in anterior, lateral, and inferior myocardial infarctions. METHODS: Acute reperfused myocardial infarction was experimentally induced in 12 pigs, with 40-minute occlusion of the left anterior descending (n = 4), left circumflex (n = 4), and right coronary arteries (n = 4). Perfusion CMR was performed during selective intracoronary gadolinium injection at the coronary occlusion site (in vivo criterion standard) and, additionally, a 7-day CMR, including T2W-STIR sequences, was performed. Finally, all animals were sacrificed and underwent postmortem Evans blue staining (classic criterion standard). RESULTS: The concordance between the CMR-based criterion standard and T2W-STIR to quantify AAR was high for anterior and inferior infarctions (r = 0.73; P = .001; mean error = 0.50%; limits = -12.68%-13.68% and r = 0.87; P = .001; mean error = -1.5%; limits = -8.0%-5.8%, respectively). Conversely, the correlation for the circumflex territories was poor (r = 0.21, P = .37), showing a higher mean error and wider limits of agreement. A strong correlation between pathology and the CMR-based criterion standard was observed (r = 0.84, P < .001; mean error = 0.91%; limits = -7.55%-9.37%). CONCLUSIONS: T2W-STIR CMR sequences are accurate to determine the AAR for anterior and inferior infarctions; however, their accuracy for lateral infarctions is poor. These findings may have important implications for the design and interpretation of clinical trials evaluating the effectiveness of cardioprotective therapies.
INTRODUCTION AND OBJECTIVES: Area at risk (AAR) quantification is important to evaluate the efficacy of cardioprotective therapies. However, postinfarction AAR assessment could be influenced by the infarcted coronary territory. Our aim was to determine the accuracy of T2-weighted short tau triple-inversion recovery (T2W-STIR) cardiac magnetic resonance (CMR) imaging for accurate AAR quantification in anterior, lateral, and inferior myocardial infarctions. METHODS: Acute reperfused myocardial infarction was experimentally induced in 12 pigs, with 40-minute occlusion of the left anterior descending (n = 4), left circumflex (n = 4), and right coronary arteries (n = 4). Perfusion CMR was performed during selective intracoronary gadolinium injection at the coronary occlusion site (in vivo criterion standard) and, additionally, a 7-day CMR, including T2W-STIR sequences, was performed. Finally, all animals were sacrificed and underwent postmortem Evans blue staining (classic criterion standard). RESULTS: The concordance between the CMR-based criterion standard and T2W-STIR to quantify AAR was high for anterior and inferior infarctions (r = 0.73; P = .001; mean error = 0.50%; limits = -12.68%-13.68% and r = 0.87; P = .001; mean error = -1.5%; limits = -8.0%-5.8%, respectively). Conversely, the correlation for the circumflex territories was poor (r = 0.21, P = .37), showing a higher mean error and wider limits of agreement. A strong correlation between pathology and the CMR-based criterion standard was observed (r = 0.84, P < .001; mean error = 0.91%; limits = -7.55%-9.37%). CONCLUSIONS: T2W-STIR CMR sequences are accurate to determine the AAR for anterior and inferior infarctions; however, their accuracy for lateral infarctions is poor. These findings may have important implications for the design and interpretation of clinical trials evaluating the effectiveness of cardioprotective therapies.
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Authors: Giuseppe Muscogiuri; Andrea Igoren Guaricci; Nicola Soldato; Riccardo Cau; Luca Saba; Paola Siena; Maria Grazia Tarsitano; Elisa Giannetta; Davide Sala; Paolo Sganzerla; Marco Gatti; Riccardo Faletti; Alberto Senatieri; Gregorio Chierchia; Gianluca Pontone; Paolo Marra; Mark G Rabbat; Sandro Sironi Journal: J Clin Med Date: 2022-09-26 Impact factor: 4.964
Authors: Xavier Rossello; Antonio Rodriguez-Sinovas; Gemma Vilahur; Verónica Crisóstomo; Inmaculada Jorge; Carlos Zaragoza; José L Zamorano; Javier Bermejo; Antonio Ordoñez; Lisardo Boscá; Jesús Vázquez; Lina Badimón; Francisco M Sánchez-Margallo; Francisco Fernández-Avilés; David Garcia-Dorado; Borja Ibanez Journal: Sci Rep Date: 2019-12-30 Impact factor: 4.379