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Infarct transmurality and adjacent segmental function as determinants of wall thickening in revascularized chronic
Martin Ugander1, Peter A Cain, Annick Perron
1Department of Clinical Physiology, Lund University Hospital, Lund, Sweden.
Insights
In ischemic heart disease, the function of adjacent heart segments significantly impacts regional wall thickening more than infarct transmurality. This finding is crucial for understanding cardiac function after heart attacks.
Area of Science:
- Cardiology
- Medical Imaging
- Cardiac Physiology
Background:
- Regional left ventricular wall thickening (WT) in ischemic heart disease (IHD) is influenced by multiple factors.
- Chronic ischemic heart disease (CIHD) patients exhibit altered WT patterns compared to healthy individuals.
- Magnetic resonance imaging (MRI) is a key tool for assessing cardiac structure and function.
Purpose of the Study:
- To investigate how infarct transmurality (IT) and adjacent segment function affect regional WT in CIHD patients.
- To compare WT in CIHD patients with that of healthy controls.
- To determine the relative influence of IT and adjacent segment dysfunction on WT.
Main Methods:
- Cine MRI and delayed enhancement MRI were used to assess function and infarction in 20 CIHD patients 6 months post-revascularization.
- Twenty age- and sex-matched healthy volunteers underwent cine MRI.
- A 12-segment model across four midventricular slices was used for quantitative analysis.
Main Results:
- WT and IT were inversely related.
- Non-infarcted segments in CIHD patients showed reduced WT compared to controls.
- WT decreased with more dysfunctional adjacent segments and higher IT.
- Adjacent segment function was a stronger determinant of WT than IT.
Conclusions:
- The number of dysfunctional adjacent segments is a more significant determinant of regional wall thickening than infarct transmurality in patients with chronic ischemic heart disease.
Background:
There are many factors which influence regional left ventricular wall thickening (WT) in ischemic heart disease (IHD). We used magnetic resonance imaging (MRI) to explore, in patients with chronic ischemic heart disease (CIHD), how regional WT is affected by both infarct transmurality (IT) and the function of adjacent segments. We also compared these findings with a group of healthy volunteers (controls).
Methods:
Twenty patients (20 men, mean age 63, range 45-80 years) were imaged with cine MRI for function and delayed enhancement MRI for infarction 6 months after revascularization. Twenty age and sex matched controls underwent cine MRI. Short-axis images were analysed using a 12-segment per slice model in four midventricular slices per subject.
Results:
WT and IT were inversely related (r(2) = 0.11, P<0.001). WT of non-infarcted segments in patients was lower than corresponding segments in controls (5.1 versus 4.6 mm, P<0.001). WT in patients decreased with an increasing number of dysfunctional adjacent segments (P<0.001) and increasing IT (P<0.001). WT was more strongly influenced by the number of dysfunctional adjacent segments (t = -22.93, P<0.001) than by IT (t = -4.50, P<0.001).
Conclusions:
The number of dysfunctional adjacent segments is a greater determinant than infarct transmurality on regional wall thickening.
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