BibTex format
@article{Rajakulasingam:2025:eurheartj/ehae667,
author = {Rajakulasingam, R and Ferreira, P and Scott, A and Khalique, Z and Azzu, A and Molto, M and Conway, M and Falaschetti, E and Cheng, K and Hammersley, D and Cantor, E and Tindale, A and Beattie, C and Banerjee, A and Wage, R and Soundarajan, RK and Dalby, M and Nielles-Vallespin, S and Pennell, D and De, Silva P},
doi = {eurheartj/ehae667},
journal = {European Heart Journal},
pages = {454--469},
title = {Characterization of dynamic changes in cardiac microstructure after reperfused ST-elevation myocardial infarction by biphasic diffusion tensor cardiovascular magnetic resonance},
url = {http://dx.doi.org/10.1093/eurheartj/ehae667},
volume = {46},
year = {2025}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - Background and Aims: Microstructural disturbances underlie dysfunctional contraction and adverse left ventricular (LV) remodelling after ST-elevation myocardial infarction (STEMI). Biphasic diffusion tensor cardiovascular magnetic resonance (DT-CMR) quantifies dynamic reorientation of sheetlets (E2A) from diastole to systole during myocardial thickening, and markers of tissue integrity (mean diffusivity [MD] and fractional anisotropy [FA]). This study investigated whether microstructural alterations identified by biphasic DT-CMR: (i) enable contrast-free detection of acute myocardial infarction (MI); (ii) associate with severity of myocardial injury and contractile dysfunction; and (iii) predict adverse LV remodelling. Methods: Biphasic DT-CMR was acquired 4 days (n=70) and 4 months (n=66) after reperfused STEMI and in healthy volunteers (HVOLs) (n=22). Adverse LV remodelling was defined as an increase in LV end-diastolic volume ≥20% at 4 months. MD and FA maps were compared with late gadolinium enhancement images. Results: Widespread microstructural disturbances were detected post-STEMI. In the acute MI zone, diastolic E2A was raised and systolic E2A reduced, resulting in reduced E2A mobility (all p<0.001 vs adjacent and remote zones and HVOLs). Acute global E2A mobility was the only independent predictor of adverse LV remodelling (odds ratio 0.77; 95% confidence interval 0.63–0.94; p=0.010). MD and FA maps had excellent sensitivity and specificity (all >90%) and inter-observer agreement for detecting MI presence and location.Conclusions: Biphasic DT-CMR identifies microstructural alterations in both diastole and systole after STEMI, enabling detection of MI presence and location as well as predicting adverse LV remodelling. DT-CMR has potential to provide a single contrast-free modality for MI detection and prognostication of patients after acute STEMI.
AU - Rajakulasingam,R
AU - Ferreira,P
AU - Scott,A
AU - Khalique,Z
AU - Azzu,A
AU - Molto,M
AU - Conway,M
AU - Falaschetti,E
AU - Cheng,K
AU - Hammersley,D
AU - Cantor,E
AU - Tindale,A
AU - Beattie,C
AU - Banerjee,A
AU - Wage,R
AU - Soundarajan,RK
AU - Dalby,M
AU - Nielles-Vallespin,S
AU - Pennell,D
AU - De,Silva P
DO - eurheartj/ehae667
EP - 469
PY - 2025///
SN - 0195-668X
SP - 454
TI - Characterization of dynamic changes in cardiac microstructure after reperfused ST-elevation myocardial infarction by biphasic diffusion tensor cardiovascular magnetic resonance
T2 - European Heart Journal
UR - http://dx.doi.org/10.1093/eurheartj/ehae667
UR - https://academic.oup.com/eurheartj/article/46/5/454/7823021?login=true
VL - 46
ER -