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Updated: Aug 9, 2026
Histological Quantification of Chronic Myocardial Infarct in Rats
Published on: December 11, 2016
Reproducibility of chronic and acute infarct size measurement by delayed enhancement-magnetic resonance imaging
Holger Thiele1, Mathias J E Kappl, Stefan Conradi
1Department of Cardiology, University of Leipzig-Heart Center, Leipzig, Germany. thielh@medizin.uni-leipzig.de
Objectives:
The aim of this study was to evaluate the reproducibility of acute and chronic infarct size (IS) by delayed enhancement (DE) magnetic resonance imaging (MRI).
Background:
Infarct size measurements can be used as surrogate end point to reduce the sample size in studies comparing different reperfusion strategies in myocardial infarction (MI). Delayed enhancement MRI is a rather new technique, and so far infarct IS reproducibility has not been established appropriately.
Methods:
In 21 patients (10 acute MI and 11 chronic MI), IS was assessed repeatedly on consecutive days by DE-MRI. Reproducibility, interobserver, and intraobserver variabilities were assessed and compared by the Bland-Altman method.
Results:
Acute and chronic IS were 17.1 +/- 19.6% (range 5.1% to 69.8%) of LV mass (%LV) and 16.9 +/- 9.9 %LV (range 2.0% to 36.0%), respectively. Infarct size difference (bias) between scan I and scan II was -0.5 %LV, and limits of agreement were +/-2.4 %LV. Mean bias (-0.7 %LV) and limits of agreement (+/-3.2%) were slightly higher for acute in comparison with chronic MI with -0.4 +/- 1.3 %LV. Intraobserver and interobserver variability was low with a mean bias of 0.3 %LV (limits of agreement +/- 1.7 %LV) and -0.7 %LV (limits of agreement +/- 2.2 %LV), respectively.
Conclusions:
Infarct size measurement by DE-MRI is an excellent tool for IS assessment, owing to its excellent repeatability in chronic and acute MI. It has therefore the potential to serve as a surrogate end point to uncover advantages of new reperfusion strategies.
Insights
Delayed enhancement MRI (DE-MRI) accurately measures infarct size (IS) in both acute and chronic myocardial infarction (MI). This technique shows excellent reproducibility, making it a valuable surrogate endpoint for evaluating new reperfusion strategies.
Area of Science:
- Cardiovascular Imaging
- Medical Diagnostics
- Radiology
Background:
- Infarct size (IS) is a crucial endpoint in myocardial infarction (MI) research.
- Accurate IS assessment is vital for evaluating reperfusion strategies.
- Delayed enhancement MRI (DE-MRI) is a novel technique for IS quantification, but its reproducibility requires validation.
Purpose of the Study:
- To assess the reproducibility of infarct size (IS) measurements using delayed enhancement MRI (DE-MRI).
- To evaluate both acute and chronic IS reproducibility in patients with myocardial infarction (MI).
Main Methods:
- DE-MRI was performed on 21 patients (10 acute MI, 11 chronic MI) with repeated scans on consecutive days.
- Infarct size (IS) was quantified as a percentage of left ventricular mass (%LV).
- Reproducibility, interobserver, and intraobserver variabilities were analyzed using the Bland-Altman method.
Main Results:
- Acute and chronic infarct sizes (IS) were measured.
- DE-MRI demonstrated excellent reproducibility with minimal bias and narrow limits of agreement between scans.
- Intraobserver and interobserver variability were low, indicating high reliability of the measurements.
Conclusions:
- Infarct size (IS) measurement by DE-MRI is a highly reproducible tool for both acute and chronic myocardial infarction (MI).
- DE-MRI's excellent repeatability supports its use as a surrogate endpoint in clinical trials.
- This technique can effectively identify advantages of novel reperfusion strategies.
