Cardiac magnetic resonance demonstrates myocardial oedema in remote tissue early after reperfused myocardial infarction

Background. - Cardiac magnetic resonance can detect myocardial oedema using myocardial transverse relaxation time (T2)-weighted sequences but quantitative data are lacking in patients evaluated early after acute myocardial infarction. Aim. - To assess the spatial distribution of T2 in patients with recent acute myocardial infarction. Methods. - Twenty-four consecutive patients (mean age 60 11 years) with acute myocardial infarction (anterior, n = 12; inferior, n = 12) were evaluated prospectively. T2 was determined using a series of breath-hold T2-weighted segmented half-Fourier turbo-spin echo sequences. No-reflow was defined as the association of early hypoenhancement and delayed enhancement in an akinetic region after a bolus injection of DOTA-Gd (0.2 mmol/kg). Results. - No-reflow was present in 13 (54%) patients and absent in 11 (46%) patients. Mean T2 was increased in the infarct region (84.9 +/- 23.7ms) compared with in the remote myocardium (62.8 +/- 10.3 ms, p=0.0001) and in control subjects (55.7 +/- 4.6 ms, p<0.0001), but also in the remote myocardium compared with control subjects (p < 0.02). In patients with no-reflow, T2 was further increased within the infarcted subendocardium compared with in patients without no-reflow (97.9 +/- 24.8 ms vs 76.3 +/- 24.7 ms, p<0.03). Peak troponin correlated with T2 (r=0.47, p<0.02) and was higher inpatients with no-reflow (297.9 +/- 249.7 mu g/L) than in patients without no-reflow (42.4 +/- 43.1 mu g/L, p = 0.003). Conclusion. - T2 was lengthened in both infarcted and remote myocardium and was influenced by the occurrence of no-reflow. (C) 2009 Elsevier Masson SAS. All rights reserved.