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Relationship between the extent of non-viable myocardium and regional left ventricular function in chronic ischemic

Arunark Kolipaka1, George P Chatzimavroudis, Richard D White

  • 1Section of Cardiovascular Imaging, Division of Radiology, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.

Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance
|June 18, 2005
PubMed

Insights

In patients with ischemic heart disease, circumferential strain is more sensitive than wall thickening to myocardial scar extent. Scar transmurality impacts wall thickening more than scar area.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Cardiac MRI

Background:

  • Chronic ischemic heart disease often involves multi-vessel coronary artery disease.
  • Myocardial scar extent and transmurality are key indicators of cardiac damage.
  • Assessing regional left ventricular (LV) function is crucial for patient management.

Purpose of the Study:

  • To define the relationship between LV regional contractile function and myocardial scar extent.
  • To compare the sensitivity of different LV function parameters to scar characteristics.

Main Methods:

  • Magnetic resonance imaging (MRI) was used in 23 patients and 5 healthy volunteers.
  • Myocardial scar was quantified by relative area (Percent Scar) and transmural extent (Transmurality).
  • Regional LV function was assessed using systolic wall thickening and midwall circumferential strain.

Main Results:

  • LV function was diminished in all scar categories compared to normal segments.
  • Systolic wall thickening significantly reduced with >50% Percent Scar or >25% Transmurality.
  • Circumferential strain significantly reduced with >25% Percent Scar or >25% Transmurality.

Conclusions:

  • Circumferential strain is more sensitive than wall thickening to scar extent.
  • Wall thickening is more sensitive to scar transmurality than scar area.
  • Both scar area and transmurality significantly impair LV contractile function.
Abstract

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