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Updated: Jul 10, 2026
Myocardial Infarction and Functional Outcome Assessment in Pigs
Published on: April 25, 2014
Short- and long-term changes in myocardial function, morphology, edema, and infarct mass after ST-segment elevation
Rasmus Sejersten Ripa1, Jens Christian Nilsson, Yongzhong Wang
1Department of Cardiology, The Heart Centre, University Hospital Rigshospitalet, Copenhagen, Denmark.
Insights
Serial MRI reveals significant recovery of left ventricular function and perfusion after ST-elevation myocardial infarction (STEMI) within the first month. Myocardial perfusion imaging predicts regional ventricular recovery post-STEMI.
Area of Science:
- Cardiovascular Imaging
- Interventional Cardiology
- Cardiac MRI
Background:
- Limited understanding of natural course after ST-elevation myocardial infarction (STEMI) despite guideline-based therapy.
- Need for comprehensive serial cardiac MRI to assess left ventricular function, edema, perfusion, and infarct size post-STEMI.
Purpose of the Study:
- Evaluate the effects of STEMI therapy on left ventricular function and perfusion.
- Test the hypothesis that myocardial perfusion by MRI predicts left ventricular function recovery.
Main Methods:
- Serial cardiac MRI (cine, edema, first-pass perfusion, late enhancement) in 58 STEMI patients.
- Imaging performed at 2 days, 1 month, and 6 months post-primary percutaneous coronary intervention.
- Assessment of ejection fraction, wall thickening, perfusion, edema, and infarct size.
Main Results:
- Significant improvement in ejection fraction within the first month post-STEMI.
- Increased systolic wall thickening and myocardial perfusion in infarct areas.
- Substantial decrease in myocardial edema and infarct size by 1 month, with stability up to 6 months.
Conclusions:
- Left ventricular function, perfusion, and infarct mass recover significantly after STEMI, primarily within the first month.
- First-pass perfusion imaging at rest shows potential to predict regional ventricular recovery.
- Serial MRI provides comprehensive insights into the healing process and functional recovery post-STEMI.
Background:
Knowledge of the natural course after an ST-elevation myocardial infarction (STEMI) treated according to guidelines is limited because comprehensive serial magnetic resonance imaging (MRI) of systolic left ventricular function, edema, perfusion, and infarct size after STEMI has not been undertaken. The aim of this study was to evaluate effects of therapy for STEMI on left ventricular function and perfusion and to test the hypothesis that myocardial perfusion by MRI predicts recovery of left ventricular function.
Methods:
Cine MRI, edema, first-pass perfusion, and late enhancement imaging were performed in 58 patients at day 2 and at 1 and 6 months after successful primary percutaneous coronary stent intervention for STEMI.
Results:
Ejection fraction increased 6.3% during the first month (P < .001) and 1.9% from 1 to 6 months (P < .06), indicating a maximal recovery very early after the infarction. The systolic wall thickening in the infarct area almost doubled (P < .001), the perfusion of infarcted myocardium increased approximately 50% (P = .02), and perfusion improved in 72% of patients. Edema decreased with a mean of 2 segments (P < .001) during the first month and another 2.5 segments from 1 to 6 months (P < .001). Infarct size decreased to 1 month (P = .01) and was unchanged from 1 to 6 months (P = .5). Baseline perfusion did not predict improvement in ejection fraction (r = 0.2, P = .2) but did predict regional systolic function (P = .03).
Conclusions:
Left ventricular function, perfusion, and infarct mass recovered substantially after STEMI, with the main part of the change within the first month. First-pass perfusion at rest appeared to predict regional ventricular recovery.
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