| Peer-Reviewed

Role of Cardiac Magnetic Resonance Imaging in Diagnosis of Myocardial Infarction

Received: 27 January 2020     Accepted: 20 February 2020     Published: 28 December 2020
Views:       Downloads:
Abstract

Introduction: Cardiac Magnetic Resonance Imaging provides an accurate and reproducible modality for the assessment of global ventricular volumes and function, and valuable in establishing a diagnosis of chronic and acute MI and distinguishing this condition from non-ischemic cardiomyopathies. Aim: To evaluate the role of cardiac Magnetic Resonance Imaging technique in diagnosis of myocardial infarction, assessment of myocardial viability. Subject and Method: The study was conducted over a period of 3 years at Assiut University Hospital. Fifty-six patients were recruited. All patients were subjected to full history taking and radiological evaluation using a 1.5-T MR system and echocardiography. Agreement regarding segmental wall motion was assessed by using Cohen’s Kappa statistics. Also ejection fraction measurement by both modalities was compared using bland-Altman plots. Agreement between Magnetic Resonance Imaging and conventional coronary angiography in detection of diseased coronary arteries was examined using Cohen’s kappa coefficient (κ). Results: It was found that ejection fraction detected by Echo were overestimated relative to Magnetic Resonance Imaging with statistically significant difference (p=0.004). While LV diameters detected by echocardiography were underestimated relative to Magnetic Resonance Imaging. Good agreement between Magnetic Resonance Imaging and Echo regarding segmental wall motion. There was positive very high correlation between the two modalities in evaluation of LV Functionality indices. Conclusion: CMR is superior to echo in evaluating left ventricular functionality indices with echo underestimating these indices except the ejection fraction which is overestimated by Echo. Moreover, CMR is better in evaluating post MI complications and associated cardiac abnormalities.

Published in International Journal of Medical Imaging (Volume 8, Issue 4)
DOI 10.11648/j.ijmi.20200804.19
Page(s) 126-137
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Myocardial Infarction (MI), Cardiac Magnetic Resonance (CMR) and Echocardiography (ECHO), Left Ventricular (LV) and Late Gadolinium Enhancement (LGE)

References
[1] Fox K, Steg P, Eagle K, Goodman S, Anderson F, Granger C, et al. GRACE investigators. Decline in rates of death and heart failure in acute coronary syndromes, 1999-2006. JAMA. 2007; 2 (297): 1892-900.
[2] Ganame J, Messalli G, Dymarkowski S, Rademakers F, Desmet W, Van de Werf F, et al. Impact of myocardial haemorrhage on left ventricular function and remodelling in patients with reperfused acute myocardial infarction. European heart journal. 2009; 3 (30): 1440-9.
[3] Dall'Armellina E, Karamitsos T, Neubauer S, Choudhury R. CMR for characterization of the myocardium in acute coronary syndromes. Nature Reviews Cardiology. 2010; 7 (11): 624-34.
[4] Lloyd-Jones D, Adams R, Brown T, Carnethon M, Dai S, De Simone G, et al. Writing Group Members. Executive summary: heart disease and stroke statistics—2010 update: a report from the American Heart Association. Circulation. 2010; 121 (7): 948-54.
[5] Grothues F, Moon J, Bellenger N, Smith G, Klein H, Pennell D. Interstudy reproducibility of right ventricular volumes, function, and mass with cardiovascular magnetic resonance. American heart journal. 2004; 147 (2): 18-23.
[6] Felker G, Shaw L, O’Connor C. Standardized Definition of Ischemic Cardiomyopathy for Use in Clinical Research. JACC. 2002; 39 (1): 210-8.
[7] Schinkel A, Bax J, Poldermans D. Clinical assessment of myocardial hibernation. Heart J 2005; 91 (1): 111-7.
[8] Hueb T, Rocha M, Siqueira S. Impact of diabetes mellitus on ischemic cardiomyopathy. Five-year follow-up. REVISION-DM trial. Diabetol Metab Syndr. 2018; 10 (1): 19.
[9] Špinar J. Hypertension and ischemic heart disease,. Cor et Vasa. 2012; 54 (6): 433-8.
[10] Rácz I, Fülöp L, Kolozsvári R. Wall motion changes in myocardial infarction in relation to the time elapsed from symptoms until revascularization. Anatol J Cardiol. 2015; 15 (5): 363-70.
[11] Krumm P. Cardiac MRI left ventricular global function index and quantitative late gadolinium enhancement in unrecognized myocardial infarction. European journal of radiology. 2017; 92 (1): 11-6.
[12] Hillenbrand H, Kim R, Parker M. Early assessment of myocardial salvage by contrast-enhanced magnetic resonance imaging. Circulation 2000; 102 (1): 1678-83.
[13] Romero J, Xue X, Gonzalez W, Garcia M. CMR imaging assessing viability in patients with chronic ventricular dysfunction due to coronary artery disease: a meta-analysis of prospective trials. JACC: Cardiovascular Imaging. 2012; 5 (5): 494-508.
[14] Camici P, Prasad S, Rimoldi O. Stunning, hibernation, and assessment of myocardial viability. Circulation. 2008; 117 (1): 103-14.
[15] Kidambi A, Sourbron S, Maredia N. Factors associated with false-negative cardiovascular magnetic resonance perfusion studies: A Clinical evaluation of magnetic resonance imaging in coronary artery disease (CE-MARC) substudy. J Magn Reson Imaging. 2016; 43 (3): 566-73.
[16] Plein S, Kidambi A, Sourbron S, Maredia N, Uddin A, Motwani M, et al. Associated factors for a false negative cardiovascular magnetic resonance perfusion study: a CE-MARC substudy. Journal of Cardiovascular Magnetic Resonance. 2013; 15 (1): P214.
[17] Bettencourt N, Ferreira N, Chiribiri A, Schuster A, Sampaio F, Santos L, et al. Additive value of magnetic resonance coronary angiography in a comprehensive cardiac magnetic resonance stress-rest protocol for detection of functionally significant coronary artery disease: a pilot study. Circulation. 2013; 6 (5): 730-8.
[18] Chattranukulchai P, Tumkosit M, Cholteesupachai J, Chaipromprasit J. Diagnostic accuracy of combined dipyridamole stress perfusion and delayed enhancement cardiovascular magnetic resonance imaging for detection of coronary artery disease. Asian Biomedicine. 2010; 4 (1): 19-25.
[19] Manka R, Kozerke S, Rutz A, Stoeck C, Boesiger P, Schwitter J. A CMR study of the effects of tissue edema and necrosis on left ventricular dyssynchrony in acute myocardial infarction: implications for cardiac resynchronization therapy. Journal of Cardiovascular Magnetic Resonance. 2012; 14 (1): 47.
[20] Sattar H, Kwong R, Wu H, Vorobiof G, Gandla V, Steel K, et al. CLINICAL PERSPECTIVE. Circulation. 2008; 118 (10): 1011-20.
[21] Kwong R, Chan A, Brown K, Chan C, Reynolds H, Tsang S, et al. CLINICAL PERSPECTIVE. Circulation. 2006; 13 (23): 2733-43.
[22] Kim H, Farzaneh-Far A, Kim R. Cardiovascular magnetic resonance in patients with myocardial infarction: current and emerging applications. Journal of the American College of Cardiology. 2009; 55 (1): 1-6.
[23] Yoon Y, Kitagawa K, Kato S, Ishida M, Nakajima H, Kurita T, et al. Prognostic value of coronary magnetic resonance angiography for prediction of cardiac events in patients with suspected coronary artery disease. Journal of the American College of Cardiology. 2012; 60 (22): 2316-22.
[24] Nordenskjöld A, Hammar P, Ahlström H, Bjerner T, Duvernoy O, Eggers K, et al. Unrecognized Myocardial Infarction Assessed by Cardiac Magnetic Resonance Imaging–Prognostic Implications. PloS one. 2016; 17 (2): e0148803.
[25] Franco A, Javidi S, Ruehm S. Delayed Myocardial Enhancement in Cardiac Magnetic Resonance Imaging. J Radiol Case Rep. 2015; 9 (6): 6-18.
[26] Bratis K, Henningsson M, Grigoratos C, Dell'Omodarme M, Chasapides K, Botnar R, et al. Image-navigated 3-dimensional late gadolinium enhancement cardiovascular magnetic resonance imaging: feasibility and initial clinical results. J Cardiovasc Magn Reson. 2017; 19 (1): 97.
[27] Woo J, Yu T, Kim W, Kim K, Kim W. Early prediction of myocardial viability after acute myocardial infarction by two-dimensional speckle tracking imaging. J Geriatr Cardiol. 2015; 12 (5): 474-81.
[28] Bogaert J, Kalantzi M, Rademakers F. Determinants and impact of microvascular obstruction in successfully reperfused ST-segment elevation myocardial infarction. Assessment by magnetic resonance imaging. Eur Radiol. 2007; 17 (1): 2572-80.
[29] Choi K, Kim R, Gubernikoff G. Transmural extent of acute myocardial infarction predicts long-term improvement in contractile function. Circulation. 2001; 104 (1): 1101-7.
[30] Roes S, Kelle S, Kaandorp T. Comparison 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. Am J Cardiol. 2007; 100 (1): 930-6.
[31] Bhatia V, Sood R, Dhiman D. Predictors of acute myocardial infarct size in STEMI patients receiving thrombolytic therapy: A delayed contrast enhanced cardiac MRI study. Indian Heart J. 2015; 67 (2): 122-7.
[32] Stone G, Selker H, Thiele H. Relationship between infarct size and outcomes following primary PCI: patient-level analysis from 10 randomized trials. J Am Coll Cardiol. 2016; 67 (1): 1674-83.
[33] Vermes E, Carbonea I, Friedricha M. Patterns of myocardial late enhancement: Typical and atypical features. Archives of Cardiovascular Disease 2012; 105 (1): 300-8.
[34] Wu K, Zerhouni E, Judd R. Prognostic significance of microvascular obstruction by magnetic resonance imaging in patients with acute myocardial infarction. Circulation. 1998; 97 (1): 765-72.
[35] Grover S, Srinivasana G, Selvanayagama J. Evaluation of Myocardial Viability With Cardiac Magnetic Resonance Imaging. Prog Cardiovasc Dis. 2011; 54 (1): 204-14.
[36] Dall'armellina E, Karia N, Lindsay A. Dynamic changes of edema and late gadolinium enhancement after acute myocardial infarction and their relationship to functional recovery and salvage index. Circ Cardiovasc Imaging 2011; 4 (1): 228-36.
[37] Kühl H, Spuentrup E, Wall A, Franke A, Schröder J, Heussen N, et al. Assessment of myocardial function with interactive non–breath-hold real-time MR imaging: comparison with echocardiography and breath-hold cine MR imaging. Radiology. 2004; 231 (1): 198-207.
[38] Gardner B, Bingham S, Allen M. Cardiac magnetic resonance versus transthoracic echocardiography for the assessment of cardiac volumes and regional function after myocardial infarction: an intrasubject comparison using simultaneous intrasubject recordings. Cardiovascular Ultrasound. 2009; 7 (1): 38.
[39] Hoffmann R, von Bardeleben S, ten Cate F, Borges A, Kasprzak J, Firschke C, et al. Assessment of systolic left ventricular function: a multi-centre comparison of cineventriculography, cardiac magnetic resonance imaging, unenhanced and contrast-enhanced echocardiography. European heart journal. 2004; 26 (6): 607-16.
[40] Dewey M, Müller M, Eddicks S, Schnapauff D, Teige F, Rutsch W, et al. Evaluation of global and regional left ventricular function with 16-slice computed tomography, biplane cineventriculography, and two-dimensional transthoracic echocardiography: comparison with magnetic resonance imaging. Journal of the American College of Cardiology. 2006; 48 (10): 2034-44.
[41] Pellikka P, She L, Holly T, Lin G, Varadarajan P, Pai R, et al. Variability in ejection fraction measured by echocardiography, gated single-photon emission computed tomography, and cardiac magnetic resonance in patients with coronary artery disease and left ventricular dysfunction. JAMA. 2018; 1 (4): e181456.
[42] Hussein R, Ibrahim A, El-Hameed A, El-Fiky A, Tantawy W. Does CMR have an additive role over echo in evaluating ischemic LV dysfunction? The Egyptian Journal of Radiology and Nuclear Medicine. 2013; 44 (3): 475-82.
[43] Yang P, Kerr A, Liu A, Liang D, Hardy C, Meyer C, et al. New real-time interactive cardiac magnetic resonance imaging system complements echocardiography. Journal of the American College of Cardiology. 1998; 32 (7): 2049-56.
Cite This Article
  • APA Style

    Ahmed Mohamed Abdel Hakam, Hisham Mostafa Imam, Hany Mohamed Abdel-Hakeem Seif, Nisreen Adel Abbas. (2020). Role of Cardiac Magnetic Resonance Imaging in Diagnosis of Myocardial Infarction. International Journal of Medical Imaging, 8(4), 126-137. https://doi.org/10.11648/j.ijmi.20200804.19

    Copy | Download

    ACS Style

    Ahmed Mohamed Abdel Hakam; Hisham Mostafa Imam; Hany Mohamed Abdel-Hakeem Seif; Nisreen Adel Abbas. Role of Cardiac Magnetic Resonance Imaging in Diagnosis of Myocardial Infarction. Int. J. Med. Imaging 2020, 8(4), 126-137. doi: 10.11648/j.ijmi.20200804.19

    Copy | Download

    AMA Style

    Ahmed Mohamed Abdel Hakam, Hisham Mostafa Imam, Hany Mohamed Abdel-Hakeem Seif, Nisreen Adel Abbas. Role of Cardiac Magnetic Resonance Imaging in Diagnosis of Myocardial Infarction. Int J Med Imaging. 2020;8(4):126-137. doi: 10.11648/j.ijmi.20200804.19

    Copy | Download

  • @article{10.11648/j.ijmi.20200804.19,
      author = {Ahmed Mohamed Abdel Hakam and Hisham Mostafa Imam and Hany Mohamed Abdel-Hakeem Seif and Nisreen Adel Abbas},
      title = {Role of Cardiac Magnetic Resonance Imaging in Diagnosis of Myocardial Infarction},
      journal = {International Journal of Medical Imaging},
      volume = {8},
      number = {4},
      pages = {126-137},
      doi = {10.11648/j.ijmi.20200804.19},
      url = {https://doi.org/10.11648/j.ijmi.20200804.19},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20200804.19},
      abstract = {Introduction: Cardiac Magnetic Resonance Imaging provides an accurate and reproducible modality for the assessment of global ventricular volumes and function, and valuable in establishing a diagnosis of chronic and acute MI and distinguishing this condition from non-ischemic cardiomyopathies. Aim: To evaluate the role of cardiac Magnetic Resonance Imaging technique in diagnosis of myocardial infarction, assessment of myocardial viability. Subject and Method: The study was conducted over a period of 3 years at Assiut University Hospital. Fifty-six patients were recruited. All patients were subjected to full history taking and radiological evaluation using a 1.5-T MR system and echocardiography. Agreement regarding segmental wall motion was assessed by using Cohen’s Kappa statistics. Also ejection fraction measurement by both modalities was compared using bland-Altman plots. Agreement between Magnetic Resonance Imaging and conventional coronary angiography in detection of diseased coronary arteries was examined using Cohen’s kappa coefficient (κ). Results: It was found that ejection fraction detected by Echo were overestimated relative to Magnetic Resonance Imaging with statistically significant difference (p=0.004). While LV diameters detected by echocardiography were underestimated relative to Magnetic Resonance Imaging. Good agreement between Magnetic Resonance Imaging and Echo regarding segmental wall motion. There was positive very high correlation between the two modalities in evaluation of LV Functionality indices. Conclusion: CMR is superior to echo in evaluating left ventricular functionality indices with echo underestimating these indices except the ejection fraction which is overestimated by Echo. Moreover, CMR is better in evaluating post MI complications and associated cardiac abnormalities.},
     year = {2020}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Role of Cardiac Magnetic Resonance Imaging in Diagnosis of Myocardial Infarction
    AU  - Ahmed Mohamed Abdel Hakam
    AU  - Hisham Mostafa Imam
    AU  - Hany Mohamed Abdel-Hakeem Seif
    AU  - Nisreen Adel Abbas
    Y1  - 2020/12/28
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ijmi.20200804.19
    DO  - 10.11648/j.ijmi.20200804.19
    T2  - International Journal of Medical Imaging
    JF  - International Journal of Medical Imaging
    JO  - International Journal of Medical Imaging
    SP  - 126
    EP  - 137
    PB  - Science Publishing Group
    SN  - 2330-832X
    UR  - https://doi.org/10.11648/j.ijmi.20200804.19
    AB  - Introduction: Cardiac Magnetic Resonance Imaging provides an accurate and reproducible modality for the assessment of global ventricular volumes and function, and valuable in establishing a diagnosis of chronic and acute MI and distinguishing this condition from non-ischemic cardiomyopathies. Aim: To evaluate the role of cardiac Magnetic Resonance Imaging technique in diagnosis of myocardial infarction, assessment of myocardial viability. Subject and Method: The study was conducted over a period of 3 years at Assiut University Hospital. Fifty-six patients were recruited. All patients were subjected to full history taking and radiological evaluation using a 1.5-T MR system and echocardiography. Agreement regarding segmental wall motion was assessed by using Cohen’s Kappa statistics. Also ejection fraction measurement by both modalities was compared using bland-Altman plots. Agreement between Magnetic Resonance Imaging and conventional coronary angiography in detection of diseased coronary arteries was examined using Cohen’s kappa coefficient (κ). Results: It was found that ejection fraction detected by Echo were overestimated relative to Magnetic Resonance Imaging with statistically significant difference (p=0.004). While LV diameters detected by echocardiography were underestimated relative to Magnetic Resonance Imaging. Good agreement between Magnetic Resonance Imaging and Echo regarding segmental wall motion. There was positive very high correlation between the two modalities in evaluation of LV Functionality indices. Conclusion: CMR is superior to echo in evaluating left ventricular functionality indices with echo underestimating these indices except the ejection fraction which is overestimated by Echo. Moreover, CMR is better in evaluating post MI complications and associated cardiac abnormalities.
    VL  - 8
    IS  - 4
    ER  - 

    Copy | Download

Author Information
  • Department of Diagnostic Radiology, Faculty of Medicine, Assiut University, Assiut, Egypt

  • Department of Diagnostic Radiology, Faculty of Medicine, Assiut University, Assiut, Egypt

  • Department of Diagnostic Radiology, Faculty of Medicine, Assiut University, Assiut, Egypt

  • Department of Diagnostic Radiology, Faculty of Medicine, Assiut University, Assiut, Egypt

  • Sections