The salvaged area at risk in reperfused acute myocardial infarction as visualized by cardiovascular magnetic resonance
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Updated: Jul 5, 2026
Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction
Published on: October 14, 2016
Matthias G Friedrich1, Hassan Abdel-Aty, Andrew Taylor
1Stephenson Cardiovascular Magnetic Resonance Centre at the Libin Cardiovascular Institute of Alberta, Department of Cardiac Sciences, University of Calgary, Alberta, Canada. matthias.friedrich@ucalgary.ca
Insights
Cardiovascular magnetic resonance (CMR) effectively visualizes reversible and irreversible myocardial injury in reperfused myocardial infarction (MI). This imaging quantifies salvaged tissue, aiding clinical decisions and research in heart attack recovery.
Area of Science:
- Cardiovascular imaging
- Myocardial infarction research
- Tissue characterization
Background:
- Early revascularization in myocardial infarction (MI) still impacts the entire area at risk.
- The extent of salvaged tissue in the area at risk has prognostic value and therapeutic potential.
- Cardiovascular magnetic resonance (CMR) can visualize the area at risk, but clinical data are limited.
Purpose of the Study:
- To characterize tissue changes within the perfusion bed of infarct-related vessels in patients with acutely reperfused MI.
- To utilize cardiovascular magnetic resonance (CMR) for this characterization.
- To assess reversible and irreversible myocardial injury.
Main Methods:
- Study included 92 patients with acute MI and successful reperfusion, plus 18 healthy controls.
- Breath-hold T2-weighted CMR visualized reversible myocardial injury.
- Contrast-enhanced ("late enhancement") CMR visualized irreversible myocardial injury.
Main Results:
- All reperfused infarcts showed both reversible and irreversible tissue injury.
- Reversible damage was consistently transmural, exceeding infarct extent by 16% (p < 0.0001).
- No significant T2 signal abnormalities were observed in control subjects.
Conclusions:
- CMR can visualize both reversible and irreversible injury in reperfused MI.
- Quantification of salvaged area after revascularization is possible.
- This quantification is an important parameter for clinical decision-making and research.
Objectives:
We aimed to characterize the tissue changes within the perfusion bed of infarct-related vessels in patients with acutely reperfused myocardial infarction (MI) using cardiovascular magnetic resonance (CMR).
Background:
Even in successful early revascularization, intermittent coronary artery occlusion affects the entire perfusion bed, also referred to as the area at risk. The extent of the salvaged area at risk contains prognostic information and may serve as a therapeutic target. Cardiovascular magnetic resonance can visualize the area at risk; yet, clinical data have been lacking.
Methods:
We studied 92 patients with acute MI and successful reperfusion 3 +/- 3 days after the event and 18 healthy control subjects. Breath-hold T2-weighted and contrast-enhanced ("late enhancement") CMR were used to visualize the reversible and the irreversible myocardial injury, respectively.
Results:
All reperfused infarcts consistently revealed a pattern with both reversibly and irreversibly injured tissue. In contrast to the infarcted area, reversible damage was always transmural, exceeding the infarct in its maximal extent by 16 +/- 11% (absolute difference of the area of maximal infarct expansion 38 +/- 15% vs. 22 +/- 10%; p < 0.0001). None of the controls had significant T2 signal intensity abnormalities.
Conclusions:
In patients with reperfused MI, CMR visualizes both reversible and irreversible injury. This allows for quantifying the extent of the salvaged area after revascularization as an important parameter for clinical decision-making and research.
