Coronary artery diseaseComparison of Myocardial Infarct Size Assessed With Contrast-Enhanced Magnetic Resonance Imaging and Left Ventricular Function and Volumes to Predict Mortality in Patients With Healed Myocardial Infarction
Section snippets
Study population
This was a prospective, follow-up study that involved 2 hospitals. Consecutive patients (n = 231), referred for MRI to evaluate cardiac function and extent of scar tissue for clinical reasons, with a history of CAD and evidence of scar tissue on contrast-enhanced MRI, were enrolled. Patients with myocardial infarction <3 months before cardiac MRI were excluded. Other exclusion criteria were (supra-) ventricular arrhythmias, pacemakers, intracranial clips, and claustrophobia. Patient
Study population
Clinical data are presented in Table 1; 231 patients with scar tissue on contrast-enhanced MRI were included (106 at the Leiden University Medical Center, The Netherlands, and 125 at the German Heart Institute, Germany). All patients had evidence of CAD on angiography and 84% had a previous myocardial infarction; 16% had a clinically unrecognized myocardial infarction. MRI was performed >2 years after infarction in 52% of the patients.
MRI variables
MRI findings are listed in Table 2. Median LVEF in the total
Discussion
The main finding in this study is that myocardial infarct size on contrast-enhanced MRI, expressed as either spatial extent, transmurality of scar tissue, or total scar score is a stronger predictor of long-term mortality than LV function and/or LV volumes in patients with healed myocardial infarction.
MRI has emerged as a reliable noninvasive technique for assessment of scar tissue in patients with CAD.12, 15 Kim et al16 validated the value of contrast-enhanced MRI to detect scar tissue in an
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