The peri-infarct zone represents the morphological substrate for re-entry ventricular tachycardia after myocardial infarction (MI) and its extent is a strong predictor of major cardiac events. Although delayed gadolinium enhancement magnetic resonance (DGE-MRI) was shown to allow for detailed characterization of MI by quantifying infarct core zone and peri-infarct zone volume, potentials of DGE-MRI for measuring changes in peri-infarct zone volume are unknown. Therefore, we aimed to assess changes in volume of the peri-infarct zone among patients with ischemic cardiomyopathy treated with chronic vasodilator therapy.
Materials and Methods
Core and peri-infarct zone volumes as assessed with DGE-MRI were measured in 5 patients at baseline and following 6 months treatment with sustained-release dipyridamole.
Core zone volume remained stable during follow-up [median(range): 19ml(9–42) vs. 16ml(11–46); p=0.785]. The ratio between the peri-infarct zone and the core zone volume decreased significantly at 6 month as compared to baseline [median(range): 0.22(0.19–0.42) vs. 0.18(0.09–0.32); p=0.043], and a trend towards reduction in peri-infarct zone volume was found [median(range): 5ml(2–8) vs. 3ml(2–6); p=0.059]. The peri-infarct zone volume decreased in all but 1 patient over the follow-up.
This initial experience suggests that reverse remodeling of the peri-infarct zone with reduction in peri-infarct zone volume may take place in patients with ischemic cardiomyopathy. Quantification of this process may be feasible with DGE-MRI, but further studies are needed to confirm this hypothesis and to further clarify the role of DGE-MRI for the assessment of changes in peri-infarct zone volume in patients with ischemic cardiomyopathy.
Keywords: Peri-infarct zone, magnetic resonance imaging, delayed gadolinium enhancement, myocardial infarction