Author + information
- Received May 28, 2008
- Revision received October 21, 2008
- Accepted October 27, 2008
- Published online February 1, 2009.
- Frank Breuckmann, MD⁎,⁎ (, )
- Kai Nassenstein, MD†,
- Christina Bucher⁎,
- Ina Konietzka‡,
- Gernot Kaiser, MD§,
- Thomas Konorza, MD⁎,
- Christoph Naber, MD⁎,
- Andreas Skyschally, PhD‡,
- Petra Gres‡,
- Gerd Heusch, MD, FRCP‡,
- Raimund Erbel, MD, FACC⁎ and
- Jörg Barkhausen, MD†
- ↵⁎Reprint requests and correspondence:
Dr. Frank Breuckmann, West German Heart Center Essen, Department of Cardiology, University Duisburg-Essen, Hufelandstr. 55, Essen D-45122, Germany
Objectives Our study aimed to detect the morphological und functional effects of coronary microembolization (ME) in vivo by cardiac magnetic resonance (CMR) imaging in an established experimental animal model.
Background Post-mortem morphological alterations of coronary ME include perifocal inflammatory edema and focal microinfarcts. Clinically, the detection of ME after successful coronary interventions identifies a population with a worse long-term prognosis.
Methods In 18 minipigs, ME was performed by intracoronary infusion of microspheres followed by repetitive in vivo imaging on a 1.5-T MR system from 30 min to 8 h after ME. Additionally, corresponding ex vivo CMR imaging and histomorphology were performed.
Results Cine CMR imaging demonstrated a time-dependent increase of wall motion abnormalities from 9 of 18 animals after 30 min to all animals after 8 h (0.5 h, 50%; 2 h, 78%; 4 h, 75%; 8 h, 100%). Whereas T2 images were negative 30 min after ME, 4 of 18 animals showed myocardial edema at follow-up (0.5 h, 0%; 2 h, 6%; 4 h, 25%; 8 h, 17%). In vivo late gadolinium enhancement (LGE) was observed in none of the animals after 30 min, but in 33%, 50%, and 83% of animals at 2 h, 4 h, and 8 h, respectively, after ME. Ex vivo CMR imaging showed patchy areas of LGE in all but 1 animal (2 h, 83%; 4 h, 100%; 8 h, 100%). A significant correlation was seen between the maximum troponin I level and LGE in vivo (r = 0.63) and the spatial extent of ex vivo LGE (r = 0.76).
Conclusions Our results show that in vivo contrast-enhanced CMR imaging allows us to detect functional and structural myocardial changes after ME with a high sensitivity. Ex vivo, the pattern of LGE of high-resolution, contrast-enhanced CMR imaging is different from the well-known pattern of LGE in compact myocardial damage. Thus, improvements in spatial resolution are thought to be necessary to improve its ability to visualize ME-induced structural alterations even in vivo.
- coronary microembolization
- magnetic resonance imaging
- contractile dysfunction
- late gadolinium enhancement
This study was supported by the German Research Foundation (Deutsche Forschungsgemeinschaft, grant BA 2115/2-1). Dr. Heusch was supported for his studies on coronary microembolization by the German Research Foundation (Deutsche Forschungsgemeinschaft, grant HE 1320/14-1).
- Received May 28, 2008.
- Revision received October 21, 2008.
- Accepted October 27, 2008.
- American College of Cardiology Foundation