Article Sidebar
Main Article Content
Abstract
ABSTRACT
Cardiac Magnetic Resonance Imaging (MRI) represents the gold standard and valuable reference tool for the assessment of myocardial viability in the post-infarction period. We report the case of a 64-year-old man with a 3-month history of non-revascularized STEMI who underwent a cardiac MRI for a myocardial viability study. His others medical history included diabetes, hypertensive and bilateral Peripheral Arterial Disease (PAD) without stroke. His clinical presentation included a heart failure and low cardiac output signs, electrocardiographic and echocardiographic signs of ischemic heart disease with severe myocardial performance decreasing. Coronary angiography revealed triple-vessel disease (TVD). Cardiac MRI revealed nonviable myocardium with the presence of an apical thrombus in the left ventricle. Given the contraindication of myocardial revascularization due to the to a myocardial nonviability, the patient was put on medical treatment. He died in the intensive care unit from cardiocirculatory failure.
RÉSUMÉ
L'imagerie par résonance magnétique (IRM) cardiaque représente l'étalon-or et un outil de référence précieux pour l'évaluation de la viabilité du myocarde dans la période post-infarctus. Nous rapportons le cas d'un homme de 64 ans, ayant des antécédents de STEMI non revascularisé depuis 3 mois, qui a subi une IRM cardiaque pour une étude de la viabilité du myocarde. Ses autres antécédents médicaux comprenaient un diabète, une hypertension et une maladie artérielle périphérique bilatérale sans accident vasculaire cérébral. Sa présentation clinique comprenait une insuffisance cardiaque et des signes de faible débit cardiaque, des signes électrocardiographiques et échocardiographiques de cardiopathie ischémique avec une diminution sévère de la performance du myocarde. La coronarographie a révélé une maladie des trois vaisseaux. L'IRM cardiaque a révélé un myocarde non viable avec la présence d'un thrombus apical dans le ventricule gauche. Étant donné la contre-indication d'une revascularisation myocardique en raison de la non-viabilité du myocarde, le patient a été mis sous traitement médical. Il est décédé dans l'unité de soins intensifs d'une défaillance cardiocirculatoire.
Keywords
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
- Thomson LE, Kim RJ, Judd RM. Magnetic resonance imaging for the assessment of myocardial viability. J Magn Reson Imaging. 2004;19:771-88.
- Souto, Ana Luiza Mansur, et al. "Myocardial viability on cardiac magnetic resonance." Arquivos brasileiros de cardiologia. 2017;108.5:458-69.
- Arai AE. Myocardial infarction and viability with an emphasis on imaging delayed enhancement. In: Kwong RY, editor. Cardiovascular magnetic resonance imaging. Totowa (NJ): Human Press Inc; 2008.351–75.
- Al-Sabeq B, Nabi F, Shah DJ. Assessment of myocardial viability by cardiac MRI. Curr Opin Cardiol. 2019;34 :502-09.
- Matthew Ryan, Holly Morgan, Amedeo Chiribiri, Eike Nagel, John Cleland, Divaka Perera, Myocardial viability testing: all STICHed up, or about to be REVIVED?, European Heart Journal. 2022;43:118–26.
- Schmidt A, Wu KC. MRI assessment of myocardial viability. Semin Ultrasound CT MR. 2006;27:11-9.
- Swan HJ, Chatterjee K, Corday E, Ganz W, Marcus H, Matloff J, Parmley W. Clinical conference: Myocardial revascularization for acute and chronic coronary heart disease. Ann Intern Med. 1973;79:851-66.
- Chatterjee K, Swan HJ, Parmley WW, Sustaita H, Marcus HS, Matloff J: Influence of direct myocardial revascularization on left ventricular asynergy and function in patients with coronary heart disease. With and without previous myocardial infarction. Circulation.1973;47:276-86.
- Rees G, Bristow JD, Kremkau EL, et al: Influence of aortocoronary bypass surgery on left ventricular performance. N Engl J Med.1971;284:1116-20.
- Gerbaud E. Prévalence de la viabilité myocardique résiduelle après syndrome coronaire aigu. Accessed on November 07th 2024 on https://www.realites-cardiologiques.com/wp-content/uploads/sites/2/2010/11/0317.pdf
- Pasquet, A., B. Gerber, and J-L. Vanoverschelde."Viabilité myocardique." EMC-Cardiologie-Angéiologie. 2005;2:86-9.
- Joodi G, Maradey JA, Bogle B, Mirzaei M, Sadaf MI, Pursell I, Henderson C, Mounsey JP, Simpson RJ Jr. Coronary Artery Disease and Atherosclerotic Risk Factors in a Population-Based Study of Sudden Death. J Gen Intern Med. 2020;35:531-37.
- Zipes DP, Wellens HJ. Sudden cardiac death. Circulation 1998;98:2334–51.
- Spencer FA, Meyer TE, Goldberg RJ, et al: Twenty year trends (1975- 1995) in the incidence, in-hospital and long-term death rates associated with heart failure complicating acute myocardial infarction: a community-wide perspective. J Am Coll Cardiol .1999;34:1378-87.
- Spencer FA, Meyer TE, Gore JM, Goldberg RJ: Heterogeneity in the management and outcomes of patients with acute myocardial infarction complicated by heart failure: The National Registry of Myocardial Infarction. Circulation. 2002;105:2605-10.
- Velazquez EJ, Francis GS, Armstrong PW, et al: An international perspective on heart failure and left ventricular systolic dysfunction complicating myocardial infarction: The VALIANT registry. Eur Heart J.2004; 25:1911-19.
- Wu AH, Parsons L, Every NR, Bates ER: Hospital outcomes in patients presenting with congestive heart failure complicating acute myocardial infarction: A report from the Second National Registry of Myocardial Infarction (NRMI-2). J Am Coll Cardiol. 2002;40:1389-94.
- Ho KK, Anderson KM, Kannel WB, Grossman W, Levy D: Survival after the onset of congestive heart failure in Framingham Heart Study subjects. Circulation. 1993;88:107-15.
- Levy D, Kenchaiah S, Larson MG, et al: Long-term trends in the incidence of and survival with heart failure. N Engl J Med. 2002;347:1397-1402,
- Nadif M. Apport de l'IRM cardiaque dans la recherche de viabilité myocardique. Accessed on November 07th 2024 on https://toubkal.imist.ma/bitstream/handle/123456789/17146/MS0602021.pdf?sequence=1.
- Kannel WB. Lessons from curbing the coronary artery disease epidemic for confronting the impending epidemic of heart failure. Med Clin North Am. 2004;88:1129-33, ix.
- Swan HJ, Chatterjee K, Corday E, et al: Clinical conference: Myocardial revascularization for acute and chronic coronary heart disease. Ann Intern Med.1973; 79:851-66.
- Chatterjee K, Swan HJ, Parmley WW, Sustaita H, Marcus HS, Matloff J: Influence of direct myocardial revascularization on left ventricular asynergy and function in patients with coronary heart disease. With and without previous myocardial infarction. Circulation. 1973; 47:276-86,
- Rees G, Bristow JD, Kremkau EL, et al: Influence of aortocoronary bypass surgery on left ventricular performance. N Engl J Med. 1971;284: 1116-20.
- Diamond GA, Forrester JS, de Luz PL, Wyatt HL, Swan HJ. Post-extrasystolic potentiation of ischemic myocardium by atrial stimulation. Am Heart J. 1978;95:204–9.
- Braunwald E, Kloner RA. The stunned myocardium: prolonged, postischemic ventricular dysfunction. Circulation. 1982;66:1146–9.
- .Rahimtoola SH. The hibernating myocardium. Am Heart J .1989;117:211–21.
- .Frangogiannis NG. Myocardial hibernation clinical and pathological perspectives. Min Cardiol Ang. 2003;51:261–74
- Jansen MA, Van Emous JG, Nederhoff MG, Van Echteld CJ. Assessment of myocardial viability by intracellular 23Na magnetic resonance imaging. Circulation. 2004;110:3457-64.
- Morbidity and mortality: 2002 chart book on cardiovascular, lung,and blood diseases. NIH, Bethesda, MD. NHLBI; 2002. 104p.
- Klein L, O’Connor CM, Gattis WA, et al. Pharmacologic therapy forpatients with chronic heart failure and reduced systolic function:review of trials and practical considerations. Am J Cardiol 2003;91:18F– 40F.
- Beanlands RS, Hendry PJ, Masters RG, deKemp RA, Woodend K,Ruddy TD. Delay in revascularization is associated with increasedmortality rate in patients with severe left ventricular dysfunctionand viable myocardium on fluorine 18-fluorodeoxyglucosepositron emission tomography imaging. Circulation. 1998;98:II51–II56
- Franz-Josef Neumann, Miguel Sousa-Uva, Anders Ahlsson, Fernando Alfonso, Adrian P Banning, Umberto Benedetto, Robert A Byrne, JeanPhilippe Collet, Volkmar Falk, Stuart J Head Adnan Kastrati, Akos Koller, Steen D Kristensen, Josef Niebauer, Dimitrios J Richter, Petar M Seferović, Dirk Sibbing, Giulio G Stefanini, Stephan Windecker, Rashmi Yadav, Michael O Zembala, 2018 ESC/EACTS Guidelines on myocardial revascularization . European Heart Journal.2019;40:87–165.
- Allman K, Shaw LJ, Hachamovitch R, Udelson J. Myocardial viability testing and impact of revascularization on prognosis in patients with coronary artery disease and left ventricular dysfunction: A meta analysis. J Am Coll Cardiol 2002;39:1151–8.
- LEE KS et al. Prognosis of patients with left ventricular dysfunction, with and without viable myocardium after myocardial infarction : relative efficacy of medical therapy and revascularization. Circulation, 1994 ; 90 : 2 687-94.
- Zouaoui, W., H. Ouldzein, and D. Carrié. Étude de la viabilité myocardique dans le post-infarctus et indications de la revascularisation. Annales de cardiologie et d'angeiologie. Vol. 59. No. 2. Elsevier Masson, 2010.
- Kim RJ, Wu E, Rafael A, Chen EL, Parker MA, Simonetti O, et al. The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction. N Engl J Med. 2000;343:1445–53.
- Kandolin RM, Wiefels CC, Mesquita CT, Chong AY, Boland P, Glineur D, Sun L, Beanlands RS, Mielniczuk LM. The Current Role of Viability Imaging to Guide Revascularization and Therapy Decisions in Patients With Heart Failure and Reduced Left Ventricular Function. Can J Cardiol. 2019;35:1015-1029.
- Dweck MR, Williams MC, Moss AJ, Newby DE, Fayad ZA. Computed tomography and cardiac magnetic resonance in ischemic heart disease. J Am Coll Cardiol 2016;68:2201–16.
- Beek A.M., Kühl H.P., Bondarenko O. Delayed contrast-enhanced magnetic resonance imaging for the prediction of regional functional improvement after acute myocardial infarction. J Am Coll Cardiol. 2003;42:895–901.
- Gutberlet M., Fröhlich M., Mehl S. Myocardial viability assessment in patients with highly impaired left ventricular function: comparison of delayed enhancement, dobutamine stress MRI, end-diastolic wall thickness, and TI201-SPECT with functional recovery after revascularization. Eur Radiol. 2005;15:872–80.
- Kim RJ, Wu E, Rafael A, Chen EL, Parker MA, Simonetti O, et al. The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction. N Engl J Med .2000;343:1445–53.
- Dastidar AG, Rodrigues JC, Baritussio A, Bucciarelli-Ducci C. MRI in the assessment of ischaemic heart disease. Heart. 2016;102:239–52.
- Jansen MA, Van Emous JG, Nederhoff MG, Van Echteld CJ. Assessment of myocardial viability by intracellular 23Na magnetic resonance imaging. Circulation. 2004 Nov 30;110 :3457-64.
References
Thomson LE, Kim RJ, Judd RM. Magnetic resonance imaging for the assessment of myocardial viability. J Magn Reson Imaging. 2004;19:771-88.
Souto, Ana Luiza Mansur, et al. "Myocardial viability on cardiac magnetic resonance." Arquivos brasileiros de cardiologia. 2017;108.5:458-69.
Arai AE. Myocardial infarction and viability with an emphasis on imaging delayed enhancement. In: Kwong RY, editor. Cardiovascular magnetic resonance imaging. Totowa (NJ): Human Press Inc; 2008.351–75.
Al-Sabeq B, Nabi F, Shah DJ. Assessment of myocardial viability by cardiac MRI. Curr Opin Cardiol. 2019;34 :502-09.
Matthew Ryan, Holly Morgan, Amedeo Chiribiri, Eike Nagel, John Cleland, Divaka Perera, Myocardial viability testing: all STICHed up, or about to be REVIVED?, European Heart Journal. 2022;43:118–26.
Schmidt A, Wu KC. MRI assessment of myocardial viability. Semin Ultrasound CT MR. 2006;27:11-9.
Swan HJ, Chatterjee K, Corday E, Ganz W, Marcus H, Matloff J, Parmley W. Clinical conference: Myocardial revascularization for acute and chronic coronary heart disease. Ann Intern Med. 1973;79:851-66.
Chatterjee K, Swan HJ, Parmley WW, Sustaita H, Marcus HS, Matloff J: Influence of direct myocardial revascularization on left ventricular asynergy and function in patients with coronary heart disease. With and without previous myocardial infarction. Circulation.1973;47:276-86.
Rees G, Bristow JD, Kremkau EL, et al: Influence of aortocoronary bypass surgery on left ventricular performance. N Engl J Med.1971;284:1116-20.
Gerbaud E. Prévalence de la viabilité myocardique résiduelle après syndrome coronaire aigu. Accessed on November 07th 2024 on https://www.realites-cardiologiques.com/wp-content/uploads/sites/2/2010/11/0317.pdf
Pasquet, A., B. Gerber, and J-L. Vanoverschelde."Viabilité myocardique." EMC-Cardiologie-Angéiologie. 2005;2:86-9.
Joodi G, Maradey JA, Bogle B, Mirzaei M, Sadaf MI, Pursell I, Henderson C, Mounsey JP, Simpson RJ Jr. Coronary Artery Disease and Atherosclerotic Risk Factors in a Population-Based Study of Sudden Death. J Gen Intern Med. 2020;35:531-37.
Zipes DP, Wellens HJ. Sudden cardiac death. Circulation 1998;98:2334–51.
Spencer FA, Meyer TE, Goldberg RJ, et al: Twenty year trends (1975- 1995) in the incidence, in-hospital and long-term death rates associated with heart failure complicating acute myocardial infarction: a community-wide perspective. J Am Coll Cardiol .1999;34:1378-87.
Spencer FA, Meyer TE, Gore JM, Goldberg RJ: Heterogeneity in the management and outcomes of patients with acute myocardial infarction complicated by heart failure: The National Registry of Myocardial Infarction. Circulation. 2002;105:2605-10.
Velazquez EJ, Francis GS, Armstrong PW, et al: An international perspective on heart failure and left ventricular systolic dysfunction complicating myocardial infarction: The VALIANT registry. Eur Heart J.2004; 25:1911-19.
Wu AH, Parsons L, Every NR, Bates ER: Hospital outcomes in patients presenting with congestive heart failure complicating acute myocardial infarction: A report from the Second National Registry of Myocardial Infarction (NRMI-2). J Am Coll Cardiol. 2002;40:1389-94.
Ho KK, Anderson KM, Kannel WB, Grossman W, Levy D: Survival after the onset of congestive heart failure in Framingham Heart Study subjects. Circulation. 1993;88:107-15.
Levy D, Kenchaiah S, Larson MG, et al: Long-term trends in the incidence of and survival with heart failure. N Engl J Med. 2002;347:1397-1402,
Nadif M. Apport de l'IRM cardiaque dans la recherche de viabilité myocardique. Accessed on November 07th 2024 on https://toubkal.imist.ma/bitstream/handle/123456789/17146/MS0602021.pdf?sequence=1.
Kannel WB. Lessons from curbing the coronary artery disease epidemic for confronting the impending epidemic of heart failure. Med Clin North Am. 2004;88:1129-33, ix.
Swan HJ, Chatterjee K, Corday E, et al: Clinical conference: Myocardial revascularization for acute and chronic coronary heart disease. Ann Intern Med.1973; 79:851-66.
Chatterjee K, Swan HJ, Parmley WW, Sustaita H, Marcus HS, Matloff J: Influence of direct myocardial revascularization on left ventricular asynergy and function in patients with coronary heart disease. With and without previous myocardial infarction. Circulation. 1973; 47:276-86,
Rees G, Bristow JD, Kremkau EL, et al: Influence of aortocoronary bypass surgery on left ventricular performance. N Engl J Med. 1971;284: 1116-20.
Diamond GA, Forrester JS, de Luz PL, Wyatt HL, Swan HJ. Post-extrasystolic potentiation of ischemic myocardium by atrial stimulation. Am Heart J. 1978;95:204–9.
Braunwald E, Kloner RA. The stunned myocardium: prolonged, postischemic ventricular dysfunction. Circulation. 1982;66:1146–9.
.Rahimtoola SH. The hibernating myocardium. Am Heart J .1989;117:211–21.
.Frangogiannis NG. Myocardial hibernation clinical and pathological perspectives. Min Cardiol Ang. 2003;51:261–74
Jansen MA, Van Emous JG, Nederhoff MG, Van Echteld CJ. Assessment of myocardial viability by intracellular 23Na magnetic resonance imaging. Circulation. 2004;110:3457-64.
Morbidity and mortality: 2002 chart book on cardiovascular, lung,and blood diseases. NIH, Bethesda, MD. NHLBI; 2002. 104p.
Klein L, O’Connor CM, Gattis WA, et al. Pharmacologic therapy forpatients with chronic heart failure and reduced systolic function:review of trials and practical considerations. Am J Cardiol 2003;91:18F– 40F.
Beanlands RS, Hendry PJ, Masters RG, deKemp RA, Woodend K,Ruddy TD. Delay in revascularization is associated with increasedmortality rate in patients with severe left ventricular dysfunctionand viable myocardium on fluorine 18-fluorodeoxyglucosepositron emission tomography imaging. Circulation. 1998;98:II51–II56
Franz-Josef Neumann, Miguel Sousa-Uva, Anders Ahlsson, Fernando Alfonso, Adrian P Banning, Umberto Benedetto, Robert A Byrne, JeanPhilippe Collet, Volkmar Falk, Stuart J Head Adnan Kastrati, Akos Koller, Steen D Kristensen, Josef Niebauer, Dimitrios J Richter, Petar M Seferović, Dirk Sibbing, Giulio G Stefanini, Stephan Windecker, Rashmi Yadav, Michael O Zembala, 2018 ESC/EACTS Guidelines on myocardial revascularization . European Heart Journal.2019;40:87–165.
Allman K, Shaw LJ, Hachamovitch R, Udelson J. Myocardial viability testing and impact of revascularization on prognosis in patients with coronary artery disease and left ventricular dysfunction: A meta analysis. J Am Coll Cardiol 2002;39:1151–8.
LEE KS et al. Prognosis of patients with left ventricular dysfunction, with and without viable myocardium after myocardial infarction : relative efficacy of medical therapy and revascularization. Circulation, 1994 ; 90 : 2 687-94.
Zouaoui, W., H. Ouldzein, and D. Carrié. Étude de la viabilité myocardique dans le post-infarctus et indications de la revascularisation. Annales de cardiologie et d'angeiologie. Vol. 59. No. 2. Elsevier Masson, 2010.
Kim RJ, Wu E, Rafael A, Chen EL, Parker MA, Simonetti O, et al. The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction. N Engl J Med. 2000;343:1445–53.
Kandolin RM, Wiefels CC, Mesquita CT, Chong AY, Boland P, Glineur D, Sun L, Beanlands RS, Mielniczuk LM. The Current Role of Viability Imaging to Guide Revascularization and Therapy Decisions in Patients With Heart Failure and Reduced Left Ventricular Function. Can J Cardiol. 2019;35:1015-1029.
Dweck MR, Williams MC, Moss AJ, Newby DE, Fayad ZA. Computed tomography and cardiac magnetic resonance in ischemic heart disease. J Am Coll Cardiol 2016;68:2201–16.
Beek A.M., Kühl H.P., Bondarenko O. Delayed contrast-enhanced magnetic resonance imaging for the prediction of regional functional improvement after acute myocardial infarction. J Am Coll Cardiol. 2003;42:895–901.
Gutberlet M., Fröhlich M., Mehl S. Myocardial viability assessment in patients with highly impaired left ventricular function: comparison of delayed enhancement, dobutamine stress MRI, end-diastolic wall thickness, and TI201-SPECT with functional recovery after revascularization. Eur Radiol. 2005;15:872–80.
Kim RJ, Wu E, Rafael A, Chen EL, Parker MA, Simonetti O, et al. The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction. N Engl J Med .2000;343:1445–53.
Dastidar AG, Rodrigues JC, Baritussio A, Bucciarelli-Ducci C. MRI in the assessment of ischaemic heart disease. Heart. 2016;102:239–52.
Jansen MA, Van Emous JG, Nederhoff MG, Van Echteld CJ. Assessment of myocardial viability by intracellular 23Na magnetic resonance imaging. Circulation. 2004 Nov 30;110 :3457-64.