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Computed Tomography In Assessment Of Myocardium Viability In Patients With Acute Myocardial Infarction Following One-Year Observation

Veselova T.N.1, Merkulova I.N.1, Ternovoy S.K.1,2, Ruda M.Ya.

Purpose. To evaluate myocardium viability and to assess prognostic value of myocardial contrast delayed enhancement with computed tomography (CT) after ST-elevation acute myocardial infarction (AMI). Materials and methods. In study 117 patients with first AMI were included. CT with contrast enhancement was performed in all patients in 3-5 days and at 12 months after AMI. In arterial phase there were evaluation of myocardial perfusion defect, end-systolic, end-diastolic volume (ESV, EDV) and ejection fraction (EF) of left ventricle (LV). In delay phase we detected 3 types of myocardial enhancement: type I – absence of delayed hyperenhancement (DHE) (viable myocardium), type II and III – myocardial DHE with residual defect (RD) and transmural myocardial DHE (nonviable myocardium). Results. Myocardial perfusion defect was less in patients with viable myocardium (type I) then in patients with nonviable myocardium (II and III types): 1 sm3 [0,4-2,4] versus 7,3 sm3 [5,3-10,0] and 6,3 sm3 [5,0-15,0], respectively, p<0,001. During the 12-month period EF increased in patients with type I compared with basic data (63,4 ± 7,6% versus 56,3 ± 6,6%, p<0,001). LV remodelling was observed in 22 (43,1%) of 51 patients with nonviable myocardium, the number of LV segments with DHE in these patients was 4,0 [4,5-6,0]. Conclusions. CT allows reliable assessment of myocardial viability in patients with AMI. Transmural DHE of the myocardium by CT can be considered as a predictor of LV re-modeling after myocardial infarction. Absence of DHE in patients with AMI is a predictor of viable myocardium and improvement of functional and morphological parameters of LV in the postinfarction period.
1 - National Medical Research Center for Cardiology. 2 - I. M. Sechenov First Moscow State Medical University (Sechenov University). Moscow, Russia.







Keywords:acute myocardial infarction, nonviable myocardium, left ventricular remodeling, computed tomography.


Corresponding author:Veselova T.N., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript


For citation: Veselova T.N., Merkulova I.N., Ternovoy S.K., Ruda M.Ya. Computed tomography in assessment of myocardium viability in patients with acute myocardial infarction following one-year observation. REJR 2017; 7(4):55-64. DOI:10.21569/2222-7415-2017-7-4-55-64.

Received: 31.10.2017 Accepted: 20.11.2017