Geavanceerde beeldvorming van myocardinfarct door middel van cardiale magnetische resonantie

Acute myocardial infarction (MI) is a leading cause of morbidity and mortality in western countries. The understanding of the pathophysiological processes occurring acutely in the infarcted myocardium and lately during post-infarction left ventricular (LV) remodeling is crucial for the development of more effective treatments. In this regard, cardiovascular magnetic resonance (CMR) has opened new perspectives for comprehensive and accurate depiction of acutely damaged myocardium and post-infarction LV remodeling. At acute phase this technique is capable of in-depth characterization of the infarcted myocardium by visualizing the myocardium at risk (ischemic myocardium nourished by occluded coronary artery), the status of coronary microvascular and the magnitude of infarction along with an accurate assessment of ventricular volumes, mass and systolic performance on regional and global basis. The repetition of the exam at mid and long term follow-up allows for an accurate assessment of post-infarction LV remodeling by measuring the morphological and functional changes occurring in the infarcted and non-infarcted myocardium (regional remodeling) and in the whole left ventricle (global remodeling). Based on these premises, our research focused on the use of comprehensive CMR approach in patients suffering an acute MI at early post-infarction phase (within 1 week from acute event) and follow-up (4 months/1 year after the acute event). We have investigated the following issues: 1) development of a novel and reproducible method to measure the regional systolic performance of the infarcted and non-infarcted myocardium using a merging of LGE and cine CMR images; 2) quantification of the extent of myocardial salvage at early post-infarction phase and how this index influences post-infarction LV remodelling and dysfunction at 4-month follow-up; 3) in-depth characterization of acute right ventricular (RV) ischemic injury and how it influences the remodelling of right ventricle at 4-month follow-up; 4) the relationship between infarct location, size and post-infarction LV remodelling; 5) the pattern of post-infarction LV remodelling up to 1 year follow-up; 6) the relationship between prodromal angina (i.e., at least one episode of typical angina in the week preceeding the acute infarction), myocardial salvage and the severity of infarction. Our research projects have prompted results, which hopefully will critically contribute to the exploration and understanding of acute ischemic myocardial damage and post-infarction ventricular remodelling.status: publishe