Related Experiment Video
Updated: Jan 2, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Blood Stasis Imaging Predicts Cerebral Microembolism during Acute Myocardial Infarction
Antonia Delgado-Montero1, Pablo Martinez-Legazpi1, M Mar Desco2
1Department of Cardiology, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, and CIBERCV, Madrid, Spain.
Insights
Quantitative imaging of left ventricular blood stasis after acute myocardial infarction predicts brain microembolism. This stasis imaging approach aids in assessing cardioembolic risk for personalized anticoagulation therapy.
Area of Science:
- Cardiology
- Neurology
- Medical Imaging
Background:
- Cardioembolic stroke is a leading cause of death and disability globally.
- Personalized anticoagulation therapy requires accurate cardioembolic risk assessment.
- Intracardiac blood stasis is a potential, yet unquantified, risk factor.
Purpose of the Study:
- To assess the relationship between left ventricular blood stasis metrics and brain microembolism.
- To evaluate image-based blood stasis as a predictor of cardioembolic risk.
- To explore the utility of stasis imaging for personalizing anticoagulation therapy.
Main Methods:
- Developed intraventricular blood stasis maps using color Doppler echocardiography in pigs with induced acute myocardial infarction (AMI).
- Calculated global and local blood stasis indices, including average residence time.
- Monitored brain microemboli (high-intensity transient signals [HITS]) via carotid Doppler ultrasound.
Main Results:
- HITS incidence increased significantly during AMI phases (0% baseline, 50% AMI-1, 90% AMI-2).
- Average blood residence time in the left ventricle correlated strongly with HITS incidence (R=0.87, P<.001) and predicted microemboli (C-index=0.89).
- Blood stasis, not conventional echocardiographic variables like apical wall motion score, best explained HITS incidence.
Conclusions:
- The degree of left ventricular blood stasis following AMI is closely linked to brain microembolism.
- Stasis imaging offers a promising method for patient-specific cardioembolic risk assessment.
- This technique supports personalized anticoagulation strategies in stroke patients.
Background:
Cardioembolic stroke is a major source of mortality and disability worldwide. The authors hypothesized that quantitative characterization of intracardiac blood stasis may be useful to determine cardioembolic risk in order to personalize anticoagulation therapy. The aim of this study was to assess the relationship between image-based metrics of blood stasis in the left ventricle and brain microembolism, a surrogate marker of cardiac embolism, in a controlled animal experimental model of acute myocardial infarction (AMI).
Methods:
Intraventricular blood stasis maps were derived from conventional color Doppler echocardiography in 10 pigs during anterior AMI induced by sequential ligation of the mid and proximal left anterior descending coronary artery (AMI-1 and AMI-2 phases). From these maps, indices of global and local blood stasis were calculated, such as the average residence time and the size and ratio of contact with the endocardium of blood regions with long residence times. The incidence of brain microemboli (high-intensity transient signals [HITS]) was monitored using carotid Doppler ultrasound.
Results:
HITS were detected in 0%, 50%, and 90% of the animals at baseline and during AMI-1 and AMI-2 phases, respectively. The average residence time of blood in the left ventricle increased in parallel. The residence time performed well to predict microemboli (C-index = 0.89, 95% CI, 0.75-1.00) and closely correlated with the number of HITS (R = 0.87, P < .001). Multivariate and mediation analyses demonstrated that the number of HITS during AMI phases was best explained by stasis. Among conventional echocardiographic variables, only apical wall motion score weakly correlated with the number of HITS (R = 0.3, P = .04). Mural thrombosis in the left ventricle was ruled out in all animals.
Conclusions:
The degree of stasis of blood in the left ventricle caused by AMI is closely related to the incidence of brain microembolism. Therefore, stasis imaging is a promising tool for a patient-specific assessment of cardioembolic risk.
More Related Videos
18:11A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
Published on: December 28, 2012
13:10Combined Near-infrared Fluorescent Imaging and Micro-computed Tomography for Directly Visualizing Cerebral Thromboemboli
Published on: September 25, 2016
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:20Imaging Studies for Cardiovascular System II:Types of Echocardiography
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:30Acute Coronary Syndrome I: Introduction
01:21Imaging Studies for Cardiovascular System IV: CMRI