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338088

APPLICATION OF CARDIAC MAGNETIC RESONANCE IMAGING (cMRI) IN EVALUATION OF MYOCARDIAL VIABILITY IN PATIENTS WITH CORONARY ARTERY DISEASE

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Last updated: 24 Dec 2024

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Abstract

Background: The principal goal of the evaluation of myocardial viability is to identify patients whose symptoms, exercise capacity, and long-term prognosis may improve after revascularization. Contrast enhanced cardiac MRI has developed as a promising imaging modality for the evaluation of myocardial viability which provides direct imaging of necrotic tissue with contrast and high spatial resolution. Objective: To assess the role of cardiac MRI as a non- invasive tool in the evaluation of myocardial viability in patients with coronary artery disease. Patients and Methods: The study included 25 patients diagnosed as having coronary artery disease (CAD), (age range, 28-68 years). All selected patients were subjected to cardiac MRI examination using 1.5-T MR system for studying myocardial function and viability. Comparison was made between echocardiography and cardiac MRI regarding segmental wall motion using the 17-segment model of the American Heart Association for assessment of myocardial function. Delayed-enhancement MRI was performed to determine myocardial viability and scarring while black blood T2W sequence with fat suppression was done to detect cases with acute infarction. Microvascular occlusion was diagnosed using early Gadolinium enhancement sequence. Results: Good agreement between cardiac MRI and echocardiography regarding segmental wall motion with P-value of 0.065. Sensitivity and specificity of cardiac MRI for detecting SWMA were 93.6%, and 44.4% respectively. Myocardial viability was evaluated by cardiac MRI with the use of end-diastolic wall thickness, imaging of early and late enhancement after contrast administration. Late gadolinium enhancement allowed assessing state of myocardium and visualizing myocardial scar with its quantification. Two segments showed 1-25% transmural extent of myocardial wall infarction, while 120 segments showed 71-100% extent and 261 segments showed no enhancing scar. Conclusion: Cardiac MR imaging is an effective and reliable method for the evaluation of myocardial function as compared to echocardiography. Also, it is effective and reliable method for the evaluation of myocardial viability being able to assess both the infarct size and transmurality and accordingly helps to predict functional recovery after revascularization.

DOI

10.21608/amj.2024.338088

Keywords

Ischemic Heart Disease (IHD), Segmental Wall Motion Abnormality (SWMA), myocardial viability, Late gadolinium enhancement

Authors

First Name

Yasser

Last Name

Gamal Metwally Abouzeid

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Affiliation

Department of Diagnostic & Interventional Radiology, Faculty of Medicine, Al-Azhar University

Email

yasserabozied42@gmail.com

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First Name

Mostafa

Last Name

Fadel Sonbol

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Affiliation

Department of Diagnostic & Interventional Radiology, Faculty of Medicine, Al-Azhar University

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First Name

Abdul Halim

Last Name

Mohammad Aboulmagd

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Affiliation

Department of Diagnostic & Interventional Radiology, Faculty of Medicine, Al-Azhar University

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Orcid

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First Name

Mohammad

Last Name

Talaat Mohammad

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-

Affiliation

Department of Cardiology, Faculty of Medicine, Al-Azhar University

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Volume

53

Article Issue

1

Related Issue

45765

Issue Date

2024-01-01

Receive Date

2024-01-24

Publish Date

2024-01-01

Page Start

57

Page End

72

Print ISSN

1110-0400

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https://amj.journals.ekb.eg/article_338088.html

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https://amj.journals.ekb.eg/service?article_code=338088

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Original Article

Type Code

941

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Journal

Publication Title

Al-Azhar Medical Journal

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https://amj.journals.ekb.eg/

MainTitle

APPLICATION OF CARDIAC MAGNETIC RESONANCE IMAGING (cMRI) IN EVALUATION OF MYOCARDIAL VIABILITY IN PATIENTS WITH CORONARY ARTERY DISEASE

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Article

Created At

24 Dec 2024