Role of Cardiac Magnetic Resonance Imaging in Detecting Myocardial Viability in Patients with Chronic Ischaemic Heart Disease: A Prospective Observational Study
Introduction: Myocardial viability refers to a phenomenon in which dysfunctional myocardium, due to acute or chronic ischaemia, retains the potential to recover its systolic function after revascularisation. The assessment of myocardial viability using Contrast-enhanced Magnetic Resonance Imaging (C...
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JCDR Research and Publications Private Limited
2025-01-01
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| author | Subhosree Dey Parul Dutta Bornali Dutta Baloy Jyoti Talukdar Sushant Agarwal Dhiraj Baruah |
| author_facet | Subhosree Dey Parul Dutta Bornali Dutta Baloy Jyoti Talukdar Sushant Agarwal Dhiraj Baruah |
| author_sort | Subhosree Dey |
| collection | DOAJ |
| description | Introduction: Myocardial viability refers to a phenomenon in which dysfunctional myocardium, due to acute or chronic ischaemia, retains the potential to recover its systolic function after revascularisation. The assessment of myocardial viability using Contrast-enhanced Magnetic Resonance Imaging (CE-MRI) has become a quintessential imaging method for the guidance of treatment in patients with Myocardial Infarction (MI).
Aim: To assess cardiac morphology, function, perfusion and myocardial viability in patients with chronic ischaemic heart disease, and to stratify patients into conservative and operative management based on the myocardial viability.
Materials and Methods: The present hospital-based prospective observational study was conducted in the Department of Radiodiagnosis, Gauhati Medical College and Hospital, Guwahati, Assam, India, from April 2021 to October 2022. A total of 50 patients with a prior history of MI and abnormal findings on electrocardiography and echocardiography were subjected to cardiac MRI (3 Tesla). Functional parameters like wall motion and Left Ventricular Ejection Fraction (LVEF) were evaluated along with perfusion scan. On Late Gadolinium Enhancement (LGE) scan, patients were classified into two categories: ≤50% LGE (viable) and >50% LGE (non viable). The quantitative values like age and LVEF were summarised as mean and Standard Deviation (SD) based on the distribution of data. A Pearson’s correlation test was done to check the correlation between various parameters. A p-value (using Chi-square test) of less than 0.05 was considered statistically significant.
Results: The mean age was 52±14 years. A total of 27 (54%) patients were males and 23 (46%) patients were females. Out of 50 patients, 17 showed an LGE score ≤50%, while 33 showed an LGE score >50%. The segments showing >50% LGE showed more severe wall motion abnormalities than those with ≤50% LGE (p-value <0.005). There was positive correlation between perfusion defect and LGE (Pearson’s correlation 0.951). Out of 17 patients in LGE ≤50% group, 15 (88.2%) patients had clinical improvement, whereas out of 33 patients in the LGE >50% group, only 2 (6.10%) patients had clinical improvement following coronary revascularisation.
Conclusion: Delayed Enhanced-Cardiac Magnetic Resonance (DE-CMR) imaging assesses severity of the infarcted myocardium and helps in predicting recovery following intervention. |
| format | Article |
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| institution | Kabale University |
| issn | 2249-782X 0973-709X |
| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-24f693d63e2b4b858d86d6887f418d2b2025-01-18T11:58:52ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2025-01-011901071310.7860/JCDR/2025/74485.20493Role of Cardiac Magnetic Resonance Imaging in Detecting Myocardial Viability in Patients with Chronic Ischaemic Heart Disease: A Prospective Observational StudySubhosree Dey0Parul Dutta1Bornali Dutta2Baloy Jyoti Talukdar3Sushant Agarwal4Dhiraj Baruah5Junior Resident, Department of Radiodiagnosis, Gauhati Medical College and Hospital, Guwahati, Assam, India.Professor, Department of Radiodiagnosis, Gauhati Medical College and Hospital, Guwahati, Assam, India.Professor, Department of Cardiology, Gauhati Medical College and Hospital and CN Centre, Guwahati, Assam, India.Junior Resident, Department of Radiodiagnosis, Gauhati Medical College and Hospital, Guwahati, Assam, India.Associate Professor, Department of Radiodiagnosis, Gauhati Medical College and Hospital, Guwahati, Assam, IndiaProfessor, Department of Radiology, Director Thoracic Imaging, Medical University of South Carolina, Charleston, South Carolina , USAIntroduction: Myocardial viability refers to a phenomenon in which dysfunctional myocardium, due to acute or chronic ischaemia, retains the potential to recover its systolic function after revascularisation. The assessment of myocardial viability using Contrast-enhanced Magnetic Resonance Imaging (CE-MRI) has become a quintessential imaging method for the guidance of treatment in patients with Myocardial Infarction (MI). Aim: To assess cardiac morphology, function, perfusion and myocardial viability in patients with chronic ischaemic heart disease, and to stratify patients into conservative and operative management based on the myocardial viability. Materials and Methods: The present hospital-based prospective observational study was conducted in the Department of Radiodiagnosis, Gauhati Medical College and Hospital, Guwahati, Assam, India, from April 2021 to October 2022. A total of 50 patients with a prior history of MI and abnormal findings on electrocardiography and echocardiography were subjected to cardiac MRI (3 Tesla). Functional parameters like wall motion and Left Ventricular Ejection Fraction (LVEF) were evaluated along with perfusion scan. On Late Gadolinium Enhancement (LGE) scan, patients were classified into two categories: ≤50% LGE (viable) and >50% LGE (non viable). The quantitative values like age and LVEF were summarised as mean and Standard Deviation (SD) based on the distribution of data. A Pearson’s correlation test was done to check the correlation between various parameters. A p-value (using Chi-square test) of less than 0.05 was considered statistically significant. Results: The mean age was 52±14 years. A total of 27 (54%) patients were males and 23 (46%) patients were females. Out of 50 patients, 17 showed an LGE score ≤50%, while 33 showed an LGE score >50%. The segments showing >50% LGE showed more severe wall motion abnormalities than those with ≤50% LGE (p-value <0.005). There was positive correlation between perfusion defect and LGE (Pearson’s correlation 0.951). Out of 17 patients in LGE ≤50% group, 15 (88.2%) patients had clinical improvement, whereas out of 33 patients in the LGE >50% group, only 2 (6.10%) patients had clinical improvement following coronary revascularisation. Conclusion: Delayed Enhanced-Cardiac Magnetic Resonance (DE-CMR) imaging assesses severity of the infarcted myocardium and helps in predicting recovery following intervention.https://jcdr.net/articles/PDF/20493/74485_CE[Ra1]__F(SHU)_QC(SD_SS)_PF1(JY_SS_OM)_redo_PFA(IS)_PB(JY_IS)_PN(IS).pdfdelayed enhanced-cardiac magnetic resonancelate gadolinium enhancementmyocardial perfusionwall motion abnormality |
| spellingShingle | Subhosree Dey Parul Dutta Bornali Dutta Baloy Jyoti Talukdar Sushant Agarwal Dhiraj Baruah Role of Cardiac Magnetic Resonance Imaging in Detecting Myocardial Viability in Patients with Chronic Ischaemic Heart Disease: A Prospective Observational Study Journal of Clinical and Diagnostic Research delayed enhanced-cardiac magnetic resonance late gadolinium enhancement myocardial perfusion wall motion abnormality |
| title | Role of Cardiac Magnetic Resonance Imaging in Detecting Myocardial Viability in Patients with Chronic Ischaemic Heart Disease: A Prospective Observational Study |
| title_full | Role of Cardiac Magnetic Resonance Imaging in Detecting Myocardial Viability in Patients with Chronic Ischaemic Heart Disease: A Prospective Observational Study |
| title_fullStr | Role of Cardiac Magnetic Resonance Imaging in Detecting Myocardial Viability in Patients with Chronic Ischaemic Heart Disease: A Prospective Observational Study |
| title_full_unstemmed | Role of Cardiac Magnetic Resonance Imaging in Detecting Myocardial Viability in Patients with Chronic Ischaemic Heart Disease: A Prospective Observational Study |
| title_short | Role of Cardiac Magnetic Resonance Imaging in Detecting Myocardial Viability in Patients with Chronic Ischaemic Heart Disease: A Prospective Observational Study |
| title_sort | role of cardiac magnetic resonance imaging in detecting myocardial viability in patients with chronic ischaemic heart disease a prospective observational study |
| topic | delayed enhanced-cardiac magnetic resonance late gadolinium enhancement myocardial perfusion wall motion abnormality |
| url | https://jcdr.net/articles/PDF/20493/74485_CE[Ra1]__F(SHU)_QC(SD_SS)_PF1(JY_SS_OM)_redo_PFA(IS)_PB(JY_IS)_PN(IS).pdf |
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