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The severity of post-infarction edema suggests a bimodal pattern, whereas the extent does not

Robert Jablonowski1, David Nordlund1, Christos Xanthis1

  • 1Department of Clinical Physiology, Clinical Sciences, Lund University and Lund University Hospital, Lund, Sweden.

Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance
|April 30, 2026
PubMed
Abstract

Insights

The severity of edema in myocardium at risk (MaR) after myocardial infarction (MI) shows a bimodal pattern, but its extent does not. This study used cardiovascular magnetic resonance (CMR) to assess MaR dynamics post-MI.

Area of Science:

  • Cardiovascular Imaging
  • Myocardial Infarction Research
  • Edema Assessment

Background:

  • Conflicting preclinical and clinical data exist regarding a bimodal pattern of edematous myocardium at risk (MaR) after acute myocardial infarction (MI).
  • Assessing the dynamics of MaR using cardiovascular magnetic resonance (CMR) is crucial for understanding post-MI changes.

Purpose of the Study:

  • To investigate the temporal dynamics of edematous myocardium at risk (MaR) following experimental acute myocardial infarction (MI).
  • To evaluate the bimodal pattern of MaR severity and extent using a comprehensive CMR protocol.

Main Methods:

  • Acute MI was induced in pigs, followed by reperfusion and serial CMR scans at multiple time points (baseline, 120 minutes, 24 hours, 7 days).
  • A comprehensive CMR protocol including T2-mapping (SSFP and TSE sequences), T2-STIR, CE-SSFP, and LGE imaging was employed.
  • MaR severity was assessed using T2 relaxation times, and MaR extent was quantified as the percentage of edematous myocardium.

Main Results:

  • The severity of edema within the MaR demonstrated a significant decrease at 24 hours compared to 120 minutes, with partial recovery by 7 days.
  • The extent of MaR showed a gradual decrease from 120 minutes to 24 hours and a further reduction by 7 days post-MI.
  • T2 mapping sequences (SSFP and TSE) revealed significant changes in edema severity over time.

Conclusions:

  • The severity of myocardial edema following acute MI suggests a bimodal pattern.
  • The extent of edematous myocardium at risk (MaR) does not follow a bimodal pattern after acute MI.
  • CMR imaging provides valuable insights into the dynamic changes of MaR post-MI.
Keywords:
CMRMyocardium at riskmyocardial edema

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