Dynamic Edematous Response of the Human Heart to Myocardial Infarction Implications for Assessing Myocardial Area at Risk and Salvage

Data de publicació: 03/10/2017

Autors de IIS La Fe

Jaume Agüero Ramón-Llin

Autor
Javier Garde Noguera

Autor

Autors aliens a IIS La Fe

Fernandez-Jimenez, Rodrigo
Barreiro-Perez, Manuel
Martin-Garcia, Ana
Sanchez-Gonzalez, Javier
Galan-Arriola, Carlos
Garcia-Prieto, Jaime
Diaz-Pelaez, Elena
Vara, Pedro
Martinez, Irene
Zamarro, Ivan
Sanz, Javier
Fuster, Valentin
Sanchez, Pedro L.
Ibanez, Borja

Grups d'Investigació

Grupo de Investigación Clínica y Traslacional en Cardiología

Investigador Principal

Esther Roselló Lletí

Abstract

BACKGROUND: Clinical protocols aimed to characterize the post-myocardial infarction (MI) heart by cardiac magnetic resonance (CMR) need to be standardized to take account of dynamic biological phenomena evolving early after the index ischemic event. Here, we evaluated the time course of edema reaction in patients with ST-segment-elevation MI by CMR and assessed its implications for myocardium-at-risk (MaR) quantification both in patients and in a large-animal model. METHODS: A total of 16 patients with anterior ST-segment-elevation MI successfully treated by primary angioplasty and 16 matched controls were prospectively recruited. In total, 94 clinical CMR examinations were performed: patients with ST-segment-elevation MI were serially scanned (within the first 3 hours after reperfusion and at 1, 4, 7, and 40 days), and controls were scanned only once. T2 relaxation time in the myocardium (T2 mapping) and the extent of edema on T2-weighted short-tau triple inversion-recovery (ie, CMR-MaR) were evaluated at all time points. In the experimental study, 20 pigs underwent 40-minute ischemia/reperfusion followed by serial CMR examinations at 120 minutes and 1, 4, and 7 days after reperfusion. Reference MaR was assessed by contrast-multidetector computed tomography during the index coronary occlusion. Generalized linear mixed models were used to take account of repeated measurements. RESULTS: In humans, T2 relaxation time in the ischemic myocardium declines significantly from early after reperfusion to 24 hours, and then increases up to day 4, reaching a plateau from which it decreases from day 7. Consequently, edema extent measured by T2-weighted short-tau triple inversion-recovery (CMR-MaR) varied with the timing of the CMR examination. These findings were confirmed in the experimental model by showing that only CMR-MaR values for day 4 and day 7 postreperfusion, coinciding with the deferred edema wave, were similar to values measured by reference contrast-multidetector computed tomography. CONCLUSIONS: Post-MI edema in patients follows a bimodal pattern that affects CMR estimates of MaR. Dynamic changes in post-ST-segment-elevation MI edema highlight the need for standardization of CMR timing to retrospectively delineate MaR and quantify myocardial salvage. According to the present clinical and experimental data, a time window between days 4 and 7 post-MI seems a good compromise solution for standardization. Further studies are needed to study the effect of other factors on these variables.

Dades de la publicació

ISSN/ISSNe:: 0009-7322, 1524-4539
Tipus:: Article
Pàgines:: 1288-1300
DOI:: 10.1161/CIRCULATIONAHA.116.025582
PubMed:: 28687712
Factor d'Impacte:: 8,950 SCImago ℠
Quartil:: Q1 SCImago ℠

Documents

No hi ha documents

Mètriques

Filiacions

Fernandez-Jimenez, Rodrigo:: Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (R.F.-J., J.A., C.G.-A., J.G.-P., J.S., V.F., B.I.)

CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.F.-J., M.B.-P., A.M.-G., J.A., C.G.-A., J.G.-P., B.G., P.L.S., B.I.)

The Zena and Michael A. Wiener CVI, Icahn School of Medicine at Mount Sinai, New York (R.F.-J., J.S., V.F.)

Hospital Universitario de Salamanca, Spain (M.B.-P., A.M.-G., E.D.-P., P.V., I.M., I.Z., B.G., P.L.S.)

Philips Healthcare, Madrid, Spain (J.S.-G.)

Cardiology Department, Hospital Universtitari i Politecnic La Fe, Valencia, Spain (J.A.)

IIS-Fundación Jiménez Díaz Hospital, Madrid, Spain (B.I.)

Ctr Nacl Invest Cardiovasc Carlos III CNIC, Madrid, Spain

CIBER Enfermedades Cardiovasc CIBERCV, Madrid, Spain

Icahn Sch Med Mt Sinai, Zena & Michael A Wiener CVI, New York, NY 10029 USA
Barreiro-Perez, Manuel:: Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (R.F.-J., J.A., C.G.-A., J.G.-P., J.S., V.F., B.I.)

CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.F.-J., M.B.-P., A.M.-G., J.A., C.G.-A., J.G.-P., B.G., P.L.S., B.I.)

The Zena and Michael A. Wiener CVI, Icahn School of Medicine at Mount Sinai, New York (R.F.-J., J.S., V.F.)

Hospital Universitario de Salamanca, Spain (M.B.-P., A.M.-G., E.D.-P., P.V., I.M., I.Z., B.G., P.L.S.)

Philips Healthcare, Madrid, Spain (J.S.-G.)

Cardiology Department, Hospital Universtitari i Politecnic La Fe, Valencia, Spain (J.A.)

IIS-Fundación Jiménez Díaz Hospital, Madrid, Spain (B.I.)

CIBER Enfermedades Cardiovasc CIBERCV, Madrid, Spain

Hosp Univ Salamanca, Salamanca, Spain
Martin-Garcia, Ana:: Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (R.F.-J., J.A., C.G.-A., J.G.-P., J.S., V.F., B.I.)

CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.F.-J., M.B.-P., A.M.-G., J.A., C.G.-A., J.G.-P., B.G., P.L.S., B.I.)

The Zena and Michael A. Wiener CVI, Icahn School of Medicine at Mount Sinai, New York (R.F.-J., J.S., V.F.)

Hospital Universitario de Salamanca, Spain (M.B.-P., A.M.-G., E.D.-P., P.V., I.M., I.Z., B.G., P.L.S.)

Philips Healthcare, Madrid, Spain (J.S.-G.)

Cardiology Department, Hospital Universtitari i Politecnic La Fe, Valencia, Spain (J.A.)

IIS-Fundación Jiménez Díaz Hospital, Madrid, Spain (B.I.)

CIBER Enfermedades Cardiovasc CIBERCV, Madrid, Spain

Hosp Univ Salamanca, Salamanca, Spain
Sanchez-Gonzalez, Javier:: Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (R.F.-J., J.A., C.G.-A., J.G.-P., J.S., V.F., B.I.)

CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.F.-J., M.B.-P., A.M.-G., J.A., C.G.-A., J.G.-P., B.G., P.L.S., B.I.)

The Zena and Michael A. Wiener CVI, Icahn School of Medicine at Mount Sinai, New York (R.F.-J., J.S., V.F.)

Hospital Universitario de Salamanca, Spain (M.B.-P., A.M.-G., E.D.-P., P.V., I.M., I.Z., B.G., P.L.S.)

Philips Healthcare, Madrid, Spain (J.S.-G.)

Cardiology Department, Hospital Universtitari i Politecnic La Fe, Valencia, Spain (J.A.)

IIS-Fundación Jiménez Díaz Hospital, Madrid, Spain (B.I.)

Philips Healthcare, Madrid, Spain
Aguero, Jaume:: Cardiology Department, Hospital Universtitari i Politecnic La Fe, Valencia, Spain (J.A.)

Ctr Nacl Invest Cardiovasc Carlos III CNIC, Madrid, Spain

CIBER Enfermedades Cardiovasc CIBERCV, Madrid, Spain

Hosp Univ & Politecn La Fe, Cardiol Dept, Valencia, Spain
Galan-Arriola, Carlos:: Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (R.F.-J., J.A., C.G.-A., J.G.-P., J.S., V.F., B.I.)

CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.F.-J., M.B.-P., A.M.-G., J.A., C.G.-A., J.G.-P., B.G., P.L.S., B.I.)

The Zena and Michael A. Wiener CVI, Icahn School of Medicine at Mount Sinai, New York (R.F.-J., J.S., V.F.)

Hospital Universitario de Salamanca, Spain (M.B.-P., A.M.-G., E.D.-P., P.V., I.M., I.Z., B.G., P.L.S.)

Philips Healthcare, Madrid, Spain (J.S.-G.)

Cardiology Department, Hospital Universtitari i Politecnic La Fe, Valencia, Spain (J.A.)

IIS-Fundación Jiménez Díaz Hospital, Madrid, Spain (B.I.)

Ctr Nacl Invest Cardiovasc Carlos III CNIC, Madrid, Spain

CIBER Enfermedades Cardiovasc CIBERCV, Madrid, Spain
Garcia-Prieto, Jaime:: Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (R.F.-J., J.A., C.G.-A., J.G.-P., J.S., V.F., B.I.)

CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.F.-J., M.B.-P., A.M.-G., J.A., C.G.-A., J.G.-P., B.G., P.L.S., B.I.)

The Zena and Michael A. Wiener CVI, Icahn School of Medicine at Mount Sinai, New York (R.F.-J., J.S., V.F.)

Hospital Universitario de Salamanca, Spain (M.B.-P., A.M.-G., E.D.-P., P.V., I.M., I.Z., B.G., P.L.S.)

Philips Healthcare, Madrid, Spain (J.S.-G.)

Cardiology Department, Hospital Universtitari i Politecnic La Fe, Valencia, Spain (J.A.)

IIS-Fundación Jiménez Díaz Hospital, Madrid, Spain (B.I.)

Ctr Nacl Invest Cardiovasc Carlos III CNIC, Madrid, Spain

CIBER Enfermedades Cardiovasc CIBERCV, Madrid, Spain
Diaz-Pelaez, Elena:: Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (R.F.-J., J.A., C.G.-A., J.G.-P., J.S., V.F., B.I.)

CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.F.-J., M.B.-P., A.M.-G., J.A., C.G.-A., J.G.-P., B.G., P.L.S., B.I.)

The Zena and Michael A. Wiener CVI, Icahn School of Medicine at Mount Sinai, New York (R.F.-J., J.S., V.F.)

Hospital Universitario de Salamanca, Spain (M.B.-P., A.M.-G., E.D.-P., P.V., I.M., I.Z., B.G., P.L.S.)

Philips Healthcare, Madrid, Spain (J.S.-G.)

Cardiology Department, Hospital Universtitari i Politecnic La Fe, Valencia, Spain (J.A.)

IIS-Fundación Jiménez Díaz Hospital, Madrid, Spain (B.I.)

Hosp Univ Salamanca, Salamanca, Spain
Vara, Pedro:: Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (R.F.-J., J.A., C.G.-A., J.G.-P., J.S., V.F., B.I.)

CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.F.-J., M.B.-P., A.M.-G., J.A., C.G.-A., J.G.-P., B.G., P.L.S., B.I.)

The Zena and Michael A. Wiener CVI, Icahn School of Medicine at Mount Sinai, New York (R.F.-J., J.S., V.F.)

Hospital Universitario de Salamanca, Spain (M.B.-P., A.M.-G., E.D.-P., P.V., I.M., I.Z., B.G., P.L.S.)

Philips Healthcare, Madrid, Spain (J.S.-G.)

Cardiology Department, Hospital Universtitari i Politecnic La Fe, Valencia, Spain (J.A.)

IIS-Fundación Jiménez Díaz Hospital, Madrid, Spain (B.I.)

Hosp Univ Salamanca, Salamanca, Spain
Martinez, Irene:: Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (R.F.-J., J.A., C.G.-A., J.G.-P., J.S., V.F., B.I.)

CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.F.-J., M.B.-P., A.M.-G., J.A., C.G.-A., J.G.-P., B.G., P.L.S., B.I.)

The Zena and Michael A. Wiener CVI, Icahn School of Medicine at Mount Sinai, New York (R.F.-J., J.S., V.F.)

Hospital Universitario de Salamanca, Spain (M.B.-P., A.M.-G., E.D.-P., P.V., I.M., I.Z., B.G., P.L.S.)

Philips Healthcare, Madrid, Spain (J.S.-G.)

Cardiology Department, Hospital Universtitari i Politecnic La Fe, Valencia, Spain (J.A.)

IIS-Fundación Jiménez Díaz Hospital, Madrid, Spain (B.I.)

Hosp Univ Salamanca, Salamanca, Spain
Zamarro, Ivan:: Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (R.F.-J., J.A., C.G.-A., J.G.-P., J.S., V.F., B.I.)

CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.F.-J., M.B.-P., A.M.-G., J.A., C.G.-A., J.G.-P., B.G., P.L.S., B.I.)

The Zena and Michael A. Wiener CVI, Icahn School of Medicine at Mount Sinai, New York (R.F.-J., J.S., V.F.)

Hospital Universitario de Salamanca, Spain (M.B.-P., A.M.-G., E.D.-P., P.V., I.M., I.Z., B.G., P.L.S.)

Philips Healthcare, Madrid, Spain (J.S.-G.)

Cardiology Department, Hospital Universtitari i Politecnic La Fe, Valencia, Spain (J.A.)

IIS-Fundación Jiménez Díaz Hospital, Madrid, Spain (B.I.)

Hosp Univ Salamanca, Salamanca, Spain
Garde, Beatriz:: Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (R.F.-J., J.A., C.G.-A., J.G.-P., J.S., V.F., B.I.)

CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.F.-J., M.B.-P., A.M.-G., J.A., C.G.-A., J.G.-P., B.G., P.L.S., B.I.)

The Zena and Michael A. Wiener CVI, Icahn School of Medicine at Mount Sinai, New York (R.F.-J., J.S., V.F.)

Hospital Universitario de Salamanca, Spain (M.B.-P., A.M.-G., E.D.-P., P.V., I.M., I.Z., B.G., P.L.S.)

Philips Healthcare, Madrid, Spain (J.S.-G.)

Cardiology Department, Hospital Universtitari i Politecnic La Fe, Valencia, Spain (J.A.)

IIS-Fundación Jiménez Díaz Hospital, Madrid, Spain (B.I.)

CIBER Enfermedades Cardiovasc CIBERCV, Madrid, Spain

Hosp Univ Salamanca, Salamanca, Spain
Sanz, Javier:: Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (R.F.-J., J.A., C.G.-A., J.G.-P., J.S., V.F., B.I.)

CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.F.-J., M.B.-P., A.M.-G., J.A., C.G.-A., J.G.-P., B.G., P.L.S., B.I.)

The Zena and Michael A. Wiener CVI, Icahn School of Medicine at Mount Sinai, New York (R.F.-J., J.S., V.F.)

Hospital Universitario de Salamanca, Spain (M.B.-P., A.M.-G., E.D.-P., P.V., I.M., I.Z., B.G., P.L.S.)

Philips Healthcare, Madrid, Spain (J.S.-G.)

Cardiology Department, Hospital Universtitari i Politecnic La Fe, Valencia, Spain (J.A.)

IIS-Fundación Jiménez Díaz Hospital, Madrid, Spain (B.I.)

Ctr Nacl Invest Cardiovasc Carlos III CNIC, Madrid, Spain

Icahn Sch Med Mt Sinai, Zena & Michael A Wiener CVI, New York, NY 10029 USA
Fuster, Valentin:: Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (R.F.-J., J.A., C.G.-A., J.G.-P., J.S., V.F., B.I.)

CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.F.-J., M.B.-P., A.M.-G., J.A., C.G.-A., J.G.-P., B.G., P.L.S., B.I.)

The Zena and Michael A. Wiener CVI, Icahn School of Medicine at Mount Sinai, New York (R.F.-J., J.S., V.F.)

Hospital Universitario de Salamanca, Spain (M.B.-P., A.M.-G., E.D.-P., P.V., I.M., I.Z., B.G., P.L.S.)

Philips Healthcare, Madrid, Spain (J.S.-G.)

Cardiology Department, Hospital Universtitari i Politecnic La Fe, Valencia, Spain (J.A.)

IIS-Fundación Jiménez Díaz Hospital, Madrid, Spain (B.I.)

Ctr Nacl Invest Cardiovasc Carlos III CNIC, Madrid, Spain

Icahn Sch Med Mt Sinai, Zena & Michael A Wiener CVI, New York, NY 10029 USA
Sanchez, Pedro L.:: Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (R.F.-J., J.A., C.G.-A., J.G.-P., J.S., V.F., B.I.)

CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.F.-J., M.B.-P., A.M.-G., J.A., C.G.-A., J.G.-P., B.G., P.L.S., B.I.)

The Zena and Michael A. Wiener CVI, Icahn School of Medicine at Mount Sinai, New York (R.F.-J., J.S., V.F.)

Hospital Universitario de Salamanca, Spain (M.B.-P., A.M.-G., E.D.-P., P.V., I.M., I.Z., B.G., P.L.S.)

Philips Healthcare, Madrid, Spain (J.S.-G.)

Cardiology Department, Hospital Universtitari i Politecnic La Fe, Valencia, Spain (J.A.)

IIS-Fundación Jiménez Díaz Hospital, Madrid, Spain (B.I.).

CIBER Enfermedades Cardiovasc CIBERCV, Madrid, Spain

Hosp Univ Salamanca, Salamanca, Spain
Ibanez, Borja:: Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (R.F.-J., J.A., C.G.-A., J.G.-P., J.S., V.F., B.I.)

CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.F.-J., M.B.-P., A.M.-G., J.A., C.G.-A., J.G.-P., B.G., P.L.S., B.I.)

The Zena and Michael A. Wiener CVI, Icahn School of Medicine at Mount Sinai, New York (R.F.-J., J.S., V.F.)

Hospital Universitario de Salamanca, Spain (M.B.-P., A.M.-G., E.D.-P., P.V., I.M., I.Z., B.G., P.L.S.)

Philips Healthcare, Madrid, Spain (J.S.-G.)

Cardiology Department, Hospital Universtitari i Politecnic La Fe, Valencia, Spain (J.A.)

IIS-Fundación Jiménez Díaz Hospital, Madrid, Spain (B.I.).

Ctr Nacl Invest Cardiovasc Carlos III CNIC, Madrid, Spain

CIBER Enfermedades Cardiovasc CIBERCV, Madrid, Spain

IIS Fdn Jimenez Diaz Hosp, Madrid, Spain