Infarct healing is a dynamic process following acute myocardial infarction

Sean D. Pokorney, José F. Rodriguez, José T. Ortiz, Daniel C. Lee, Robert O. Bonow, Edwin Wu*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

37 Scopus citations

Abstract

Background: The role of infarct size on left ventricular (LV) remodeling in heart failure after an acute ST-segment elevation myocardial infarction (STEMI) is well recognized. Infarct size, as determined by cardiovascular magnetic resonance (CMR), decreases over time. The amount, rate, and duration of infarct healing are unknown. Methods: A total of 66 patients were prospectively enrolled after reperfusion for an acute STEMI. Patients underwent a CMR evaluation within 1 week, 4 months, and 14 months after STEMI. Results: Mean infarct sizes for the 66 patients at baseline (acute necrosis), early follow-up (early scar), and late follow-up (late scar) were 25 ± 17 g, 17 ± 12 g, and 15 ± 11 g, respectively. Patients were stratified in tertiles, based on infarct size, with the largest infarcts having the greatest absolute decrease in mass at early and late scar. The percent reduction of infarct mass was independent of initial infarct size. There was an 8 g or 32% decrease in infarct mass between acute necrosis and early scar (p ≥ 0.01) with a 2 g or 12% additional decrease in infarct mass between early and late scar (p ≥ 0.01). Conclusions: Infarct healing is a continuous process after reperfusion for STEMI, with greatest reduction in infarct size in the first few months. The dynamic nature of infarct healing through the first year after STEMI indicates that decisions based on infarct size, and interventions to reduce infarct size, must take into consideration the time frame of measurement.

Original languageEnglish (US)
Article number62
JournalJournal of Cardiovascular Magnetic Resonance
Volume14
Issue number1
DOIs
StatePublished - 2012

Keywords

  • Acute coronary syndrome
  • Cardiovascular magnetic resonance
  • Infarct size
  • Late gadolinium enhancement
  • Remodeling

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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