Thorac Cardiovasc Surg 2008; 56 - P51
DOI: 10.1055/s-2008-1037894

HeAT: Integrated analysis of delayed enhancement and cine MRI to study regional and global remodeling after revascularization

K Müllerleile 1, D Saering 2, A Stork 3, GK Lund 3, H Handels 2, G Adam 4, T Meinertz 1, H Reichenspurner 1
  • 1University Medical Center Hamburg-Eppendorf, Center for Cardiology and Cardiovascular Surgery, Hamburg, Germany
  • 2University Medical Center Hamburg-Eppendorf, Institut für medizinische Informatik, Hamburg, Germany
  • 3Roentgeninstitut Duesseldorf, Duesseldorf, Germany
  • 4University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg, Germany

Purpose: To develop a software for the integrated analysis of myocardial viability and function by delayed enhancement (DE) – and cine MRI: Heart Analysis Tool (HeAT).

Methods: The HeAT-Software was tested in 10 patients who underwent cine and DE-MRI 5±3 days and 9±5 months after reperfused myocardial infarction (MI). Corresponding short axis images were acquired, covering the whole left ventricle (LV). Epi- and endocardial contours were manually traced on systolic and diastolic cine MR images and automatically transferred to corresponding DE-MR images. A threshold method was used for DE-MRI to delineate infarcted myocardium. The LV circumference was subdivided in 100 chords and data for regional wall thickening, diastolic wall-thickness, infarct transmurality and infarct extension were exported to a spread-sheet for graphical display.

Results: Wall thickening improved mainly in the border zone of the infarcted region. The core of the infarction showed no recovery in function. Global parameters: ejection fraction decreased from 60 to 58% (ns), infarct-mass from 37 to 21 gr (P<0.05), end-diastolic volume increased from 176 to 211ml (P<0.05).

Conclusion: HeAT enables an integrated analysis of regional wall motion and viability, using information from cine and DE-MRI. Processes of regional and global remodeling can be expressed as changes in infarct transmurality, mass and circumferential extent in relation to regional function. Use of this software will improve the monitoring of therapeutic interventions after myocardial infarction in vivo.