Yuko Tada1, Shahriar Heidary1, Atsushi Tachibana1, Junaid Zaman1, Evgenios Neofytou1, Rajesh Dash1, Joseph C Wu1, Phillip C Yang2. 1. Department of Medicine (Cardiovascular Medicine) and Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, United States of America. 2. Department of Medicine (Cardiovascular Medicine) and Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, United States of America. Electronic address: phillip@stanford.edu.
Abstract
BACKGROUND: Manganese-enhanced MRI (MEMRI) detects viable cardiomyocytes based on the intracellular manganese uptake via L-type calcium-channels. This study aimed to quantify myocardial viability based on manganese uptake by viable myocardium in the infarct core (IC), peri-infarct region (PIR) and remote myocardium (RM) using T1 mapping before and after MEMRI and assess their association with cardiac function and arrhythmogenesis. METHODS: Fifteen female swine had a 60-minute balloon ischemia-reperfusion injury in the LAD. MRI (Signa 3T, GE Healthcare) and electrophysiological study (EPS) were performed 4 weeks later. MEMRI and delayed gadolinium-enhanced MRI (DEMRI) were acquired on LV short axis. The DEMRI positive total infarct area was subdivided into the regions of MEMRI-negative non-viable IC and MEMRI-positive viable PIR. T1 mapping was performed to evaluate native T1, post-MEMRI T1, and delta R1 (R1post-R1pre, where R1 equals 1/T1) of each territory. Their correlation with LV function and EPS data was assessed. RESULTS: PIR was characterized by intermediate native T1 (1530.5 ± 75.2 ms) compared to IC (1634.7 ± 88.4 ms, p = 0.001) and RM (1406.4 ± 37.9 ms, p < 0.0001). Lower post-MEMRI T1 of PIR (1136.3 ± 99.6 ms) than IC (1262.6 ± 126.8 ms, p = 0.005) and higher delta R1 (0.23 ± 0.08 s-1) of PIR than IC (0.18 ± 0.09 s-1, p = 0.04) indicated higher myocardial manganese uptake of PIR compared to IC. Post-MEMRI T1 (r = -0.57, p = 0.02) and delta R1 (r = 0.51, p = 0.04) of PIR correlated significantly with LVEF. CONCLUSIONS: PIR is characterized by higher manganese uptake compared to the infarct core. In the subacute phase post-IR, PIR viability measured by post-MEMRI T1 correlates with cardiac function.
BACKGROUND: Manganese-enhanced MRI (MEMRI) detects viable cardiomyocytes based on the intracellular manganese uptake via L-type calcium-channels. This study aimed to quantify myocardial viability based on manganese uptake by viable myocardium in the infarct core (IC), peri-infarct region (PIR) and remote myocardium (RM) using T1 mapping before and after MEMRI and assess their association with cardiac function and arrhythmogenesis. METHODS: Fifteen female swine had a 60-minute balloon ischemia-reperfusion injury in the LAD. MRI (Signa 3T, GE Healthcare) and electrophysiological study (EPS) were performed 4 weeks later. MEMRI and delayed gadolinium-enhanced MRI (DEMRI) were acquired on LV short axis. The DEMRI positive total infarct area was subdivided into the regions of MEMRI-negative non-viable IC and MEMRI-positive viable PIR. T1 mapping was performed to evaluate native T1, post-MEMRI T1, and delta R1 (R1post-R1pre, where R1 equals 1/T1) of each territory. Their correlation with LV function and EPS data was assessed. RESULTS: PIR was characterized by intermediate native T1 (1530.5 ± 75.2 ms) compared to IC (1634.7 ± 88.4 ms, p = 0.001) and RM (1406.4 ± 37.9 ms, p < 0.0001). Lower post-MEMRI T1 of PIR (1136.3 ± 99.6 ms) than IC (1262.6 ± 126.8 ms, p = 0.005) and higher delta R1 (0.23 ± 0.08 s-1) of PIR than IC (0.18 ± 0.09 s-1, p = 0.04) indicated higher myocardial manganese uptake of PIR compared to IC. Post-MEMRI T1 (r = -0.57, p = 0.02) and delta R1 (r = 0.51, p = 0.04) of PIR correlated significantly with LVEF. CONCLUSIONS: PIR is characterized by higher manganese uptake compared to the infarct core. In the subacute phase post-IR, PIR viability measured by post-MEMRI T1 correlates with cardiac function.
Authors: Robert J Burns; Raymond J Gibbons; Qilong Yi; Robin S Roberts; Todd D Miller; Gary L Schaer; Jeffrey L Anderson; Salim Yusuf Journal: J Am Coll Cardiol Date: 2002-01-02 Impact factor: 24.094
Authors: Andrew T Yan; Adolphe J Shayne; Kenneth A Brown; Sandeep N Gupta; Carmen W Chan; Tuan M Luu; Marcelo F Di Carli; H Glenn Reynolds; William G Stevenson; Raymond Y Kwong Journal: Circulation Date: 2006-06-26 Impact factor: 29.690
Authors: H Arheden; M Saeed; C B Higgins; D W Gao; P C Ursell; J Bremerich; R Wyttenbach; M W Dae; M F Wendland Journal: Radiology Date: 2000-05 Impact factor: 11.105
Authors: Sebastian Flacke; John S Allen; Jon M Chia; James H Wible; M Peri Periasamy; Max D Adams; I Kofi Adzamli; Christine H Lorenz Journal: Radiology Date: 2003-01-24 Impact factor: 11.105
Authors: Pippa Storey; Peter G Danias; Mark Post; Wei Li; Peter R Seoane; Phillip P Harnish; Robert R Edelman; Pottumarthi V Prasad Journal: Invest Radiol Date: 2003-10 Impact factor: 6.016
Authors: Gabriele A Krombach; Maythem Saeed; Charles B Higgins; Victor Novikov; Michael F Wendland Journal: Radiology Date: 2004-01 Impact factor: 11.105