Myocardial Salvage Imaging: Where Are We and Where Are We Heading? A Cardiac Magnetic Resonance Perspective View Full Text


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Article Info

DATE

2018-02-24

AUTHORS

Luca Arcari, Chiara Bucciarelli-Ducci, Marco Francone, Luciano Agati

ABSTRACT

Purpose of ReviewCardiac magnetic resonance (CMR) has emerged in recent years as a reliable tool to assess, in a single examination after a reperfused myocardial infarction, the initially area at risk (AAR), the final infarct size (IS), and from their difference the salvaged myocardium (SM). The aim of the present review is to summarize recent advances in the CMR imaging of SM.Recent FindingsWhile there is consensus on the use of late gadolinium enhancement (LGE) to calculate IS, how to assess the AAR is a debated topic. The use of T2-weighted short-TI inversion recovery (T2W-STIR) is to date supported by a large amount of data, but it is affected by several limitations. Newer techniques have been developed to overcome T2W-STIR limitations, some of them have been already used in randomized clinical trials (RCTs) while others are showing promising results. The use of CMR to generate surrogate endpoints in RCTs is gaining attention; in this context, analysis of data from recent RCTs suggests that the assessment of SM as outcome measure could be useful to reduce sample sizes and costs of trials.SummaryCMR is a reliable technique for the assessment of SM. LGE is the gold standard for IS measurement, while which is the best technique for the evaluation of AAR is still debated. When using CMR-derived endpoints in RCTs, the assessment of SM is advisable. More... »

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References to SciGraph publications

  • 2013-05-01. Standardized image interpretation and post processing in cardiovascular magnetic resonance: Society for Cardiovascular Magnetic Resonance (SCMR) Board of Trustees Task Force on Standardized Post Processing in JOURNAL OF CARDIOVASCULAR MAGNETIC RESONANCE
  • 2011-09-14. Cardiac magnetic resonance imaging parameters as surrogate endpoints in clinical trials of acute myocardial infarction in TRIALS
  • 2011-02-18. T2-weighted cardiovascular magnetic resonance in acute cardiac disease in JOURNAL OF CARDIOVASCULAR MAGNETIC RESONANCE
  • 2017-08-01. Quantification of both the area-at-risk and acute myocardial infarct size in ST-segment elevation myocardial infarction using T1-mapping in JOURNAL OF CARDIOVASCULAR MAGNETIC RESONANCE
  • 2009-12-30. T2 quantification for improved detection of myocardial edema in JOURNAL OF CARDIOVASCULAR MAGNETIC RESONANCE
  • 2009-06-12. Scintigraphic evaluation of routine filterwire distal protection in percutaneous coronary intervention for acute ST-segment elevation myocardial infarction: a randomized controlled trial in JOURNAL OF NUCLEAR CARDIOLOGY
  • 2015-08-12. T1 mapping and T2 mapping at 3T for quantifying the area-at-risk in reperfused STEMI patients in JOURNAL OF CARDIOVASCULAR MAGNETIC RESONANCE
  • 2014-07-02. Reproducibility of area at risk assessment in acute myocardial infarction by T1- and T2-mapping sequences in cardiac magnetic resonance imaging in comparison to Tc99m-sestamibi SPECT in THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING
  • 2010-04-30. Assessment of myocardium at risk with contrast enhanced steady-state free precession cine cardiovascular magnetic resonance compared to single-photon emission computed tomography in JOURNAL OF CARDIOVASCULAR MAGNETIC RESONANCE
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