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Hamshere S, Jones DA, Pellaton C, Longchamp D, Burchell T, Mohiddin S, Moon JC, Kastrup J, Locca D, Petersen SE, Westwood M, Mathur A. Cardiovascular magnetic resonance imaging of myocardial oedema following acute myocardial infarction: Is whole heart coverage necessary? J Cardiovasc Magn Reson 2016; 18:7. [PMID: 26803468 PMCID: PMC4724400 DOI: 10.1186/s12968-016-0226-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 01/12/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND AAR measurement is useful when assessing the efficacy of reperfusion therapy and novel cardioprotective agents after myocardial infarction. Multi-slice (Typically 10-12) T2-STIR has been used widely for its measurement, typically with a short axis stack (SAX) covering the entire left ventricle, which can result in long acquisition times and multiple breath holds. This study sought to compare 3-slice T2-short-tau inversion recovery (T2- STIR) technique against conventional multi-slice T2-STIR technique for the assessment of area at risk (AAR). METHODS CMR imaging was performed on 167 patients after successful primary percutaneous coronary intervention. 82 patients underwent a novel 3-slice SAX protocol and 85 patients underwent standard 10-slice SAX protocol. AAR was obtained by manual endocardial and epicardial contour mapping followed by a semi- automated selection of normal myocardium; the volume was expressed as mass (%) by two independent observers. RESULTS 85 patients underwent both 10-slice and 3-slice imaging assessment showing a significant and strong correlation (intraclass correlation coefficient = 0.92;p < 0.0001) and a low Bland-Altman limit (mean difference -0.03 ± 3.21%, 95% limit of agreement,- 6.3 to 6.3) between the 2 analysis techniques. A further 82 patients underwent 3-slice imaging alone, both the 3-slice and the 10-slice techniques showed statistically significant correlations with angiographic risk scores (3-slice to BARI r = 0.36, 3-slice to APPROACH r = 0.42, 10-slice to BARI r = 0.27, 10-slice to APPROACH r = 0.46). There was low inter-observer variability demonstrated in the 3-slice technique, which was comparable to the 10-slice method (z = 1.035, p = 0.15). Acquisition and analysis times were quicker in the 3-slice compared to the 10-slice method (3-slice median time: 100 seconds (IQR: 65-171 s) vs. (10-slice time: 355 seconds (IQR: 275-603 s); p < 0.0001. CONCLUSIONS AAR measured using 3-slice T2-STIR technique correlates well with standard 10-slice techniques, with no significant bias demonstrated in assessing the AAR. The 3-slice technique requires less time to perform and analyse and is therefore advantageous for both patients and clinicians.
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Affiliation(s)
- Stephen Hamshere
- Department of Cardiology, Barts Heart Centre, St Bartholomews Hospital, Barts Health NHS Trust, London, EC1A 7BE, UK.
| | - Daniel A Jones
- Department of Cardiology, Barts Heart Centre, St Bartholomews Hospital, Barts Health NHS Trust, London, EC1A 7BE, UK.
- William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Unit at Barts, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK.
| | - Cyril Pellaton
- Department of Cardiology, Barts Heart Centre, St Bartholomews Hospital, Barts Health NHS Trust, London, EC1A 7BE, UK.
| | - Danielle Longchamp
- Department of Cardiology, Barts Heart Centre, St Bartholomews Hospital, Barts Health NHS Trust, London, EC1A 7BE, UK.
| | - Tom Burchell
- Department of Cardiology, Barts Heart Centre, St Bartholomews Hospital, Barts Health NHS Trust, London, EC1A 7BE, UK.
| | - Saidi Mohiddin
- Department of Cardiology, Barts Heart Centre, St Bartholomews Hospital, Barts Health NHS Trust, London, EC1A 7BE, UK.
| | - James C Moon
- Department of Cardiology, Barts Heart Centre, St Bartholomews Hospital, Barts Health NHS Trust, London, EC1A 7BE, UK.
| | - Jens Kastrup
- Department of Cardiology, Rigshopitale, University of Copenhagen, Copenhagen, Denmark.
| | - Didier Locca
- Department of Cardiology, Barts Heart Centre, St Bartholomews Hospital, Barts Health NHS Trust, London, EC1A 7BE, UK.
- Service de Cardiologie et Département de Médecine Interne, Centre Hospitalier Universitaire, Vaudois, Lausanne, Switzerland.
| | - Steffen E Petersen
- Department of Cardiology, Barts Heart Centre, St Bartholomews Hospital, Barts Health NHS Trust, London, EC1A 7BE, UK.
- William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Unit at Barts, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK.
| | - Mark Westwood
- Department of Cardiology, Barts Heart Centre, St Bartholomews Hospital, Barts Health NHS Trust, London, EC1A 7BE, UK.
| | - Anthony Mathur
- Department of Cardiology, Barts Heart Centre, St Bartholomews Hospital, Barts Health NHS Trust, London, EC1A 7BE, UK.
- William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Unit at Barts, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK.
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