Author + information
- Received September 17, 2012
- Revision received October 11, 2012
- Accepted October 11, 2012
- Published online March 1, 2013.
- Martin Hadamitzky, MD⁎,†,⁎ (, )
- Birgit Langhans, MD†,‡,
- Jörg Hausleiter, MD⁎,
- Carolin Sonne, MD⁎,
- Adnan Kastrati, MD⁎,
- Stefan Martinoff, MD†,
- Albert Schömig, MD⁎ and
- Tareq Ibrahim, MD⁎
- ↵⁎Reprint requests and correspondence:
Dr. Martin Hadamitzky, Deutsches Herzzentrum, Lazarettstrasse 36, 80636 München, Germany
Objectives This study sought to compare cardiac magnetic resonance (CMR) and single-photon emission computed tomography (SPECT) for assessment of area at risk, scar size, and salvage area after coronary reperfusion in acute myocardial infarction.
Background Myocardial salvage is an important surrogate endpoint assessing the success of coronary reperfusion in acute myocardial infarction. SPECT, the established modality for assessment of myocardial salvage, requires radiopharmaceutical injection before revascularization and 2 examinations. The combination of T2 and late enhancement imaging in CMR can assess myocardial salvage in 1 examination, but up to now, data comparing both modalities are very limited.
Methods We analyzed 207 patients who were treated by primary revascularization in acute myocardial infarction and who underwent both SPECT and CMR for assessment of myocardial salvage. In CMR, T2-weighted turbo spin echo sequences for area at risk and contrast-enhanced inversion recovery gradient echo sequences were performed.
Results Image quality was insufficient in 27 patients (13%). In the remaining 180 patients, mean area at risk was 29.4 ± 18.7% of the left ventricle (LV), and infarct size was 14.7 ± 16.9% LV, resulting in a mean salvage area of 14.9 ± 15.1% LV in SPECT, whereas in CMR, mean area at risk was 28.0 ± 14.5% LV, and infarct size was 16.0 ± 13.5% LV, resulting in a mean salvage area of 11.9 ± 12.3%. Results of both modalities correlated well for area at risk (r = 0.80), scar size (r = 0.87), and salvage area (r = 0.66, all p < 0.0001).
Conclusions Assessment of the salvage area by CMR using T2 and late enhancement imaging correlates well with the established modality of SPECT. CMR therefore may be an alternative to paired SPECT imaging for myocardial salvage assessment, but the contraindications of the modality and limitations in the established T2 imaging sequences currently cause a considerable rate of data loss.
This trial was supported in part by a research grant from the “Förderverein des Deutschen Herzzentrums,” Munich, Germany. Dr. Hausleiter has received an unrestricted research grant not related to the study topic from Siemens Medical Solutions. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received September 17, 2012.
- Revision received October 11, 2012.
- Accepted October 11, 2012.
- American College of Cardiology Foundation