Differentiation of acute and four-week old myocardial infarct with GdABE-DTTA-enhanced CMRReportar como inadecuado

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Journal of Cardiovascular Magnetic Resonance

, 12:22

First Online: 07 April 2010Received: 02 December 2009Accepted: 07 April 2010


BackgroundStandard extracellular cardiovascular magnetic resonance CMR contrast agents CA do not provide differentiation between acute and older myocardial infarcts MI. The purpose of this study was to develop a method for differentiation between acute and older myocardial infarct using myocardial late-enhancement LE CMR by a new, low molecular weight contrast agent.

Dogs n = 6 were studied in a closed-chest, reperfused, double myocardial infarct model. Myocardial infarcts were generated by occluding the Left Anterior Descending LAD coronary artery with an angioplasty balloon for 180 min, and four weeks later occluding the Left Circumflex LCx coronary artery for 180 min. LE images were obtained on day 3 and day 4 after second myocardial infarct, using GdDTPA standard extracellular contrast agent and GdABE-DTTA new, low molecular weight contrast agent, respectively. Triphenyltetrazolium chloride TTC histomorphometry validated existence and location of infarcts. Hematoxylin-eosin and Masson-s trichrome staining provided histologic evaluation of infarcts.

ResultsGdABE-DTTA or GdDTPA highlighted the acute infarct, whereas the four-week old infarct was visualized by GdDTPA, but not by GdABE-DTTA. With GdABE-DTTA, the mean ± SD signal intensity enhancement SIE was 366 ± 166% and 24 ± 59% in the acute infarct and the four-week old infarct, respectively P < 0.05. The latter did not differ significantly from signal intensity in healthy myocardium P = NS. GdDTPA produced signal intensity enhancements which were similar in acute 431 ± 124% and four-week old infarcts 400 ± 124%, P = NS, and not statistically different from the GdABE-DTTA-induced SIE in acute infarct. The existence and localization of both infarcts were confirmed by triphenyltetrazolium chloride TTC. Histologic evaluation demonstrated coagulation necrosis, inflammation, and multiple foci of calcification in the four day old infarct, while the late subacute infarct showed granulation tissue and early collagen deposition.

ConclusionsLate enhancement CMR with separate administrations of standard extracellular contrast agent, GdDTPA, and the new low molecular weight contrast agent, GdABE-DTTA, differentiates between acute and late subacute infarct in a reperfused, double infarct, canine model.

Electronic supplementary materialThe online version of this article doi:10.1186-1532-429X-12-22 contains supplementary material, which is available to authorized users.

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Autor: Robert Kirschner - Levente Toth - Akos Varga-Szemes - Tamas Simor - Pal Suranyi - Pal Kiss - Balazs Ruzsics - Attila Toth

Fuente: https://link.springer.com/article/10.1186/1532-429X-12-22

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