Cardiac magnetic resonance imaging in assessment of left ventricular function and myocardial viability in patients with chronic ischemic heart disease

摘要

Background The assessment of myocardial viability has become an integrated part in the diagnosis of patients with chronic ischemic heart disease (IHD). The available evidence suggests that patients with preserved viability will show improvement in function and symptoms after revascularization. In contrast, patients without viability will not benefit from revascularization, and the high risk and unnecessary surgical intervention should be avoided. The aim of the study The aim of this study was to evaluate the role of cardiac magnetic resonance imaging in assessment of global and regional LV function and myocardial viability in patients with chronic IHD. Methods Sixty patients with chronic IHD with reduced LVEF and who had documented myocardial infarction referred for viability assessment were included in this study. Cardiac magnetic resonance imaging adopting cine images to assess LV function and late gadolinium enhanced MRI to assess myocardial viability were implemented. Results Of the examined 1020 segments, 44 patients had 221 segments (21.7%) with thinned myocardium and their end diastolic wall thickness (EDWT) less than 5.5 mm, of which 205 segments (92.8%) had transmural infarction, 15 segments showed subendocardial infarction less than 50% and 1 segment had no delayed enhancement. 628 segments (61.57%) had no evidence of delayed enhancement, 84 segments (8.23%) had subendocardial enhancement less than or equal to 50% of the wall thickness and 308 segments (30.20%) had more than 50% of the wall thickness or transmural infarction. Conclusion Contrast-enhanced magnetic resonance imaging can be used to visualize the transmural extent of myocardial infarction with high spatial resolution. LGE-CMR imaging represents the new gold standard in the detection of irreversibly damaged myocardium.