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Circulation. 2018 May 1;137(18):1949-1964. doi: 10.1161/CIRCULATIONAHA.117.030693.

Cardiovascular Magnetic Resonance in Acute ST-Segment-Elevation Myocardial Infarction: Recent Advances, Controversies, and Future Directions.

Author information

1
Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., D.J.H.).
2
Royal Papworth Hospital, Cambridge, United Kingdom (H.B.).
3
Biomedical Imaging Research Institute and Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (R.D.).
4
Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles (R.D.).
5
Laboratory for Advanced Cardiovascular Imaging, National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD (A.E.A.).
6
British Heart Foundation Glasgow Cardiovascular Research Center, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (C.B.).
7
Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., D.J.H.). derek.hausenloy@duke-nus.edu.sg.
8
National Institute of Health Research University College London Hospitals Biomedical Research Centre, United Kingdom (D.J.H.).
9
Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom (D.J.H.).
10
National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore (D.J.H.).
11
Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore, Singapore (D.J.H.).
12
Yong Loo Lin School of Medicine, National University Singapore, Singapore (D.J.H.).

Abstract

Although mortality after ST-segment elevation myocardial infarction (MI) is on the decline, the number of patients developing heart failure as a result of MI is on the rise. Apart from timely reperfusion by primary percutaneous coronary intervention, there is currently no established therapy for reducing MI size. Thus, new cardioprotective therapies are required to improve clinical outcomes after ST-segment-elevation MI. Cardiovascular magnetic resonance has emerged as an important imaging modality for assessing the efficacy of novel therapies for reducing MI size and preventing subsequent adverse left ventricular remodeling. The recent availability of multiparametric mapping cardiovascular magnetic resonance imaging has provided new insights into the pathophysiology underlying myocardial edema, microvascular obstruction, intramyocardial hemorrhage, and changes in the remote myocardial interstitial space after ST-segment-elevation MI. In this article, we provide an overview of the recent advances in cardiovascular magnetic resonance imaging in reperfused patients with ST-segment-elevation MI, discuss the controversies surrounding its use, and explore future applications of cardiovascular magnetic resonance in this setting.

KEYWORDS:

ST elevation myocardial infarction; hemorrhage; magnetic resonance imaging; percutaneous coronary intervention

PMID:
29712696
PMCID:
PMC5933067
[Available on 2018-11-01]
DOI:
10.1161/CIRCULATIONAHA.117.030693

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