Related Experiment Video
Updated: Dec 4, 2025
Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping
Published on: September 25, 2019
Associations between the size and location of myocardial infarction and cerebral infarction
Alexander E Merkler1, Javid Alakbarli2, Tarek Barbar2
1Department of Neurology, Weill Cornell Medical College, New York, NY, USA; Clinical and Translational Neuroscience Unit, Weill Cornell Medical College, New York, NY, USA.
Background:
Myocardial infarction (MI) is a known cause of cerebral infarction. We assessed whether the size and location of MI is associated with the risk of cerebral infarction.
Methods And Results:
We performed a cross-sectional study of adults who underwent both brain MRI and delayed-enhancement cardiac MRI (DE-CMR) within 365 days of each other at Weill Cornell Medicine between 2014 and 2017 and had evidence of MI on DE-CMR. We used multiple logistic regression to evaluate associations between MI size and any cerebral infarction, apical MI location and any cerebral infarction, and MI size/location and cortical versus subcortical cerebral infarction. Models were adjusted for demographics, and the total number of vascular risk factors. Among 234 patients who underwent both DE-CMR and brain MRI within 365 days, 76 had evidence for MI on DE-CMR. Among these 76 patients, 51 (67.1%) had evidence of cerebral infarction. The size of MI (global MI burden) was not associated with any cerebral infarction (OR per 5% increase in MI size, 1.12; 95% CI, 0.85-1.47), but was associated with cortical cerebral infarction (OR per 5% increase in MI size, 1.30; 95% CI, 1.00.-1.68). Similarly, apical MI location was not associated with any cerebral infarction (OR 2.63, 95% CI, 0.78-8.87), but was associated with cortical cerebral infarction (OR, 3.67; 95% CI, 1.19-11.33).
Conclusion:
Among patients with MI on cardiac MRI, both size and apical location of MI were associated with cortical cerebral infarction. Our results may help stratify cardioembolic risk and inform antithrombotic treatment algorithms among patients with MI.
Insights
Myocardial infarction (MI) size and apical location are linked to cortical cerebral infarction, not all strokes. This finding aids in assessing cardioembolic risk in MI patients.
Area of Science:
- Cardiology
- Neurology
- Radiology
Background:
- Myocardial infarction (MI) is a recognized cause of cerebral infarction.
- The relationship between MI characteristics and cerebral infarction risk requires further investigation.
Purpose of the Study:
- To determine if the size and location of myocardial infarction (MI) correlate with the risk of cerebral infarction.
- To investigate the association between MI characteristics and the specific types of cerebral infarction (cortical vs. subcortical).
Main Methods:
- A cross-sectional study involving adults who had both brain MRI and delayed-enhancement cardiac MRI (DE-CMR) within 365 days.
- Analysis of 76 patients with evidence of MI on DE-CMR, using logistic regression adjusted for demographics and vascular risk factors.
- Evaluation of associations between MI size/apical location and any cerebral infarction, as well as cortical versus subcortical cerebral infarction.
Main Results:
- Of 76 patients with MI, 51 (67.1%) had cerebral infarction.
- MI size was not associated with any cerebral infarction but was linked to cortical cerebral infarction (OR per 5% increase, 1.30).
- Apical MI location was associated with cortical cerebral infarction (OR, 3.67) but not any cerebral infarction.
Conclusions:
- In patients with MI, both the size and apical location of the infarction are associated with cortical cerebral infarction.
- These findings can help stratify cardioembolic risk and guide antithrombotic treatment strategies in MI patients.
