Continua la RMC aportando grandes datos del proceso de cicatrización después de IAM con elevación del segmento ST y las implicaciones que esos cambios tienen a nivel de los parametros ventriculares, mostrandose claramente como este método puede ayudar al seguimiento de la evolución temporal de los procesos isquémicos agudos.
Cardiac Magnetic Resonance Evaluation of
Edema After ST-Elevation Acute Myocardial
Infarction
José V. Monmeneua, Vicente Bodíb, Juan Sanchisb, María P. López-Lereua, Luis Mainarb, Julio Núñezb,Fabián Chaustreb, Eva Rumizb, Francisco J. Chorrob y Ángel Llácerb
Unidad de Imagen Cardiaca. Hospital Clínico Universitario de Valencia. Valencia. España.
Servicio de Cardiología. Hospital Clínico Universitario de Valencia. Valencia. España
Introduction and objectives. The aims of the study were to characterize myocardial edema after ST-elevation acute myocardial infarction using cardiac magnetic resonance imaging and to investigate its impact onventricular function and its subsequent evolution.
Methods. In total, 134 patients admitted to hospital for a first ST-elevation myocardial infarction who had a patent infarct-related artery underwent cardiac magnetic resonance imaging. Cine images (at rest and with low-dose dobutamine) and edema, perfusion and viability images were acquired. Imaging was repeated after 6 months.
Results. In the first week after infarction, edema was detected in at least one segment in 96.6% of patients (4±2.1 segments per patient). Extensive edema (≥4 segments) was associated with large ventricular enddiastolic and end-systolic volumes (P<.0001), a small left ventricular ejection fraction at rest (P=.001) and with lowdose dobutamine (P=.006), a large number of segments showing hypoperfusion (P=.001) or microvascular obstruction (P=.009), a more extensive infarct (P=.017) and greater transmural extent of the infarct (P=.003). The association between the presence and extent of edema during the first week and functional, perfusion and viability variables was still observable after 6 months. No patient exhibited edema at 6 months.
Conclusions. Cardiac magnetic resonance imaging was useful for characterizing the myocardial edema that occurred after ST-elevation acute myocardial infarction. Extensive edema was with poor left ventricular characteristics. Edema was a transitory phenomenon that vanished within 6 months.
Rev Esp Cardiol. 2009;62(8):858-66
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