Related Experiment Video
Updated: Jul 20, 2026
Noninvasive Assessment of Cardiac Abnormalities in Experimental Autoimmune Myocarditis by Magnetic Resonance Microscopy Imaging in the Mouse
Published on: June 20, 2014
The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction
1Feinberg Cardiovascular Research Institute, and Department of Medicine, Northwestern University Medical School, Chicago, IL 60611-3008, USA. r-kim4@northwestern.edu
Background:
Recent studies indicate that magnetic resonance imaging (MRI) after the administration of contrast material can be used to distinguish between reversible and irreversible myocardial ischemic injury regardless of the extent of wall motion or the age of the infarct. We hypothesized that the results of contrast-enhanced MRI can be used to predict whether regions of abnormal ventricular contraction will improve after revascularization in patients with coronary artery disease.
Methods:
Gadolinium-enhanced MRI was performed in 50 patients with ventricular dysfunction before they underwent surgical or percutaneous revascularization. The transmural extent of hyperenhanced regions was postulated to represent the transmural extent of nonviable myocardium. The extent of regional contractility at the same locations was determined by cine MRI before and after revascularization in 41 patients.
Results:
Contrast-enhanced MRI showed hyperenhancement of myocardial tissue in 40 of 50 patients before revascularization. In all patients with hyperenhancement the difference in image intensity between hyperenhanced regions and regions without hyperenhancement was more than 6 SD. Before revascularization, 804 of the 2093 myocardial segments analyzed (38 percent) had abnormal contractility, and 694 segments (33 percent) had some areas of hyperenhancement. In an analysis of all 804 dysfunctional segments, the likelihood of improvement in regional contractility after revascularization decreased progressively as the transmural extent of hyperenhancement before revascularization increased (P<0.001). For instance, contractility increased in 256 of 329 segments (78 percent) with no hyperenhancement before revascularization, but in only 1 of 58 segments with hyperenhancement of more than 75 percent of tissue. The percentage of the left ventricle that was both dysfunctional and not hyperenhanced before revascularization was strongly related to the degree of improvement in the global mean wall-motion score (P<0.001) and the ejection fraction (P<0.001) after revascularization.
Conclusions:
Reversible myocardial dysfunction can be identified by contrast-enhanced MRI before coronary revascularization.
Insights
Contrast-enhanced MRI can identify reversible myocardial dysfunction before revascularization in patients with coronary artery disease. This imaging technique helps predict which areas of abnormal heart contraction will improve after treatment.
Area of Science:
- Cardiology
- Medical Imaging
- Cardiovascular Research
Background:
- Magnetic resonance imaging (MRI) with contrast material aids in distinguishing reversible from irreversible myocardial ischemic injury.
- The extent of wall motion or infarct age does not preclude MRI's ability to assess injury.
- This study investigates MRI's predictive capability for improving ventricular contraction post-revascularization.
Purpose of the Study:
- To determine if contrast-enhanced MRI results can predict the improvement of abnormal ventricular contraction after revascularization in patients with coronary artery disease.
- To assess the relationship between myocardial scar extent (hyperenhancement) and functional recovery.
- To evaluate the utility of MRI in guiding revascularization decisions.
Main Methods:
- Gadolinium-enhanced MRI was performed on 50 patients with ventricular dysfunction prior to revascularization.
- Transmural extent of hyperenhancement on MRI was used to estimate nonviable myocardium.
- Regional contractility was assessed using cine MRI before and after revascularization in 41 patients.
Main Results:
- Hyperenhancement was observed in 40 of 50 patients before revascularization.
- A significant inverse relationship was found between the transmural extent of hyperenhancement and the likelihood of contractility improvement (P<0.001).
- Segments without hyperenhancement showed a 78% improvement rate, while those with >75% hyperenhancement had only a 1.7% improvement rate.
Conclusions:
- Contrast-enhanced MRI effectively identifies reversible myocardial dysfunction before coronary revascularization.
- The extent of myocardial hyperenhancement on MRI is a strong predictor of functional recovery after revascularization.
- MRI findings can guide therapeutic strategies for patients with coronary artery disease and ventricular dysfunction.
More Related Videos
08:13In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
06:29Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
Related Concept Videos
01:24Magnetic Resonance Imaging
01:20Imaging Studies for Cardiovascular System II:Types of Echocardiography
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for diagnosing...
01:21Imaging Studies for Cardiovascular System IV: CMRI
01:28Imaging Studies for Cardiovascular System V: CT
01:30Acute Coronary Syndrome III: Diagnostic Studies