Myocardial Salvage Imaging: Where Are We and Where Are We Heading? A Cardiac Magnetic Resonance Perspective

Luca Arcari*, Chiara Bucciarelli-Ducci, Marco Francone, Luciano Agati

*Corresponding author for this work

Research output: Contribution to journalReview article (Academic Journal)peer-review

3 Citations (Scopus)
226 Downloads (Pure)

Abstract

Purpose of Review: Cardiac magnetic resonance (CMR) has emerged in recent years as a reliable tool to assess, in a single examination after a reperfused myocardial infarction, the initially area at risk (AAR), the final infarct size (IS), and from their difference the salvaged myocardium (SM). The aim of the present review is to summarize recent advances in the CMR imaging of SM. Recent Findings: While there is consensus on the use of late gadolinium enhancement (LGE) to calculate IS, how to assess the AAR is a debated topic. The use of T2-weighted short-TI inversion recovery (T2W-STIR) is to date supported by a large amount of data, but it is affected by several limitations. Newer techniques have been developed to overcome T2W-STIR limitations, some of them have been already used in randomized clinical trials (RCTs) while others are showing promising results. The use of CMR to generate surrogate endpoints in RCTs is gaining attention; in this context, analysis of data from recent RCTs suggests that the assessment of SM as outcome measure could be useful to reduce sample sizes and costs of trials. Summary: CMR is a reliable technique for the assessment of SM. LGE is the gold standard for IS measurement, while which is the best technique for the evaluation of AAR is still debated. When using CMR-derived endpoints in RCTs, the assessment of SM is advisable.

Original languageEnglish
Article number8
Number of pages8
JournalCurrent Cardiovascular Imaging Reports
Volume11
Issue number4
Early online date24 Feb 2018
DOIs
Publication statusPublished - 1 Apr 2018

Keywords

  • Area at risk
  • Cardiac magnetic resonance
  • Clinical trials
  • Infarct size
  • Myocardial infarction
  • Salvaged myocardium

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