Diffusion Tensor Imaging and Evaluation of Cardiac Ischemic Disorders: A Systematic Review

Area of Science:

• Cardiovascular Imaging
• Biomedical Engineering
• Radiology

Background:

• Myocardial infarction (MI) significantly impacts cardiac function, necessitating improved diagnostic methods beyond invasive procedures like cardiac biopsy.
• Diffusion Tensor Imaging (DTI) offers a potential non-invasive alternative for assessing myocardial structural changes.

Purpose of the Study:

• To systematically review the utility of DTI in diagnosing and characterizing myocardial infarction (MI) and associated cardiac remodeling.
• To evaluate DTI's potential as a diagnostic tool compared to existing methods.

Main Methods:

• A systematic review of articles from 2010-2023 in major electronic databases (PubMed, Scopus, Embase, Scholar).
• Inclusion criteria focused on DTI evaluation in MI patients versus standard myocardial structure, excluding studies solely on ischemic disorders.
• Methodological quality assessed using the QUADAS-2 tool.

Main Results:

• Sixteen articles (6 human, 10 animal) were selected, revealing consistent DTI index changes in infarcted regions (lower FA, RD, AD; higher MD).
• These trends were observed in both acute and chronic MI, and during microstructure remodeling assessment.
• Findings were confirmed in preclinical human studies, suggesting DTI's diagnostic potential.

Conclusions:

• Observed trends in DTI indices for acute (AMI) and chronic (CMI) myocardial infarction suggest their suitability as diagnostic markers.
• Further research is recommended to explore factors like B-value and environmental conditions influencing DTI.
• Limitations included small sample sizes and potential bias in patient selection.