Cardiac MR Characterization of left ventricular remodeling in a swine model of infarct followed by reperfusion

John Whitaker, Cory M. Tschabrunn, Jihye Jang, Eran Leshem, Mark O'Neill, Warren J. Manning, Elad Anter, Reza Nezafat*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Myocardial infarction (MI) survivors are at risk of complications including heart failure and malignant arrhythmias. Purpose: We undertook serial imaging of swine following MI with the aim of characterizing the longitudinal left ventricular (LV) remodeling in a translational model of ischemia-reperfusion-mediated MI. Animal Model: Eight Yorkshire swine underwent mid left anterior descending coronary artery balloon occlusion to create an ischemia-reperfusion experimental model of MI. Field Strength/Sequences: 1.5T Philips Achieva scanner. Serial cardiac MRI was performed at 16, 33, and 62 days post-MI, including cine imaging, native and postcontrast T1, T2 and dark-blood late gadolinium enhanced (DB-LGE) scar imaging. Assessment: Regions of interest were selected on the parametric maps to assess native T1 and T2 in the infarct and in remote tissue. Volume of enhanced tissue, nonenhanced tissue, and gray zone were assessed from DB-LGE imaging. Volumes, cardiac function, and strain were calculated from cine imaging. Statistical Tests: Parameters estimated at more than two timepoints were compared with a one-way repeated measures analysis of variance. Parametric mapping data were analyzed using a generalized linear mixed model corrected for multiple observations. A result was considered statistically significant at P < 0.05. Results: All animals developed anteroseptal akinesia and hyperenhancement on DB-LGE with a central core of nonenhancing tissue. Mean hyperenhancement volume did not change during the observation period, while the central core contracted from 2.2 ± 1.8 ml at 16 days to 0.08 ± 0.19 ml at 62 days (P = 0.008). Native T1 of ischemic myocardium increased from 1173 ± 93 msec at 16 days to 1309 ± 97 msec at 62 days (P < 0.001). Mean radial and circumferential strain rate magnitude in remote myocardium increased with time from the infarct (P < 0.05). Date Conclusion: In this swine model of MI, serial quantitative cardiac MR exams allow characterization of LV remodeling and scar formation. Level of Evidence: 2. Technical Efficacy: Stage 2. J. Magn. Reson. Imaging 2018;48:808–817.

Original languageEnglish
Pages (from-to)808-817
Number of pages10
JournalJournal of Magnetic Resonance Imaging
Volume48
Issue number3
DOIs
StatePublished - Sep 2018
Externally publishedYes

Funding

FundersFunder number
Medical Research Council UKMR/N001877/1, 5T32HL007374-37
National Institutes of Health5R01HL129185, R21-01027971
American Heart Association15EIA22710040

    Keywords

    • cardiac magnetic resonance (CMR) imaging
    • ischemia-reperfusion injury
    • left ventricular remodeling
    • sudden cardiac death (SCD)

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