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Sustained postinfarction myocardial oedema in humans visualised by magnetic resonance imaging
J C Nilsson1, G Nielsen, B A Groenning
1Danish Research Centre of Magnetic Resonance, H:S Hvidovre Hospital, University of Copenhagen, Kettegaard Allé 30, DK-2650 Hvidovre, Denmark. jenschrn@magnet.drcmr.dk
Objective:
To demonstrate postinfarction myocardial oedema in humans with particular reference to the longitudinal course, using magnetic resonance imaging (MRI).
Design:
Prospective observational study. Subjects were studied one week, one month, three months, six months, and one year after presenting with a myocardial infarct.
Setting:
Cardiology and magnetic resonance departments in a Danish university hospital.
Patients:
10 patients (three women, seven men), mean (SEM) age 58.2 (3.20) years, with a first transmural myocardial infarct.
Main Outcome Measures:
Location and duration of postinfarction myocardial oedema.
Results:
All patients had signs of postinfarction myocardial oedema. The magnetic resonance images were evaluated by two blinded procedures, employing two MRI and two ECG observers: (1) MRI determined oedema location was compared with the ECG determined site of infarction and almost complete agreement was found; (2) the time course of postinfarction myocardial oedema was explored semiquantitatively, using an image ranking procedure. Myocardial oedema was greatest at the initial examination one week after the infarction, with a gradual decline during the following months (Spearman's rank correlation analysis: rho(observer 1) = 0.94 (p < 0.0001) and rho(observer 2) = 0.97 (p < 0.0001)). The median duration of oedema was six months.
Conclusions:
Postinfarction myocardial oedema seems surprisingly long lasting. This observation is of potential clinical interest because the oedema may have prognostic significance.