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Chronic Iron Deposition following Acute Hemorrhagic Myocardial Infarction: A Cardiovascular Magnetic Resonance Study

Kali, Avinash and Kumar, Andreas and Cokic, Ivan and Tsaftaris, Sotirios A. and Friedrich, Matthias G and Dharmakumar, Rohan Chronic Iron Deposition following Acute Hemorrhagic Myocardial Infarction: A Cardiovascular Magnetic Resonance Study. Circulation: Cardiovascular Imaging, 126. A10912. ISSN 1941-9651 (2012)

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Introduction - Intramyocardial hemorrhage frequently occurs in large reperfused myocardial infarctions (MI). However, its long-term fate remains unexplored. Hypothesis - We hypothesize that intramyocardial hemorrhage, secondary to reperfused MI, results in chronic iron deposition within infarcted territories. Methods - We studied 15 patients by Cardiovascular Magnetic Resonance (CMR) T2* mapping (1.5T) on day 3 and 6 months after successful percutaneous coronary intervention for first STEMI. Using the same CMR protocol, we also studied 20 canines, on days 3 and 56 post ischemia-reperfusion injury, of which 3 animals received sham procedures. Subsequently, canine hearts were explanted, imaged ex-vivo, and samples of hemorrhagic infarcts (Hemo+), non-hemorrhagic infarcts (Hemo-), remote and sham myocardium were isolated, sectioned and mass spectrometry was performed. Results - Eleven patients had Hemo+ (verified by T2* CMR on day 3) and their scar tissue T2* values remained significantly lower after 6 months, when compared to Hemo- and remote myocardium (Fig 1; p<0.001). In canines, Hemo+ territories showed a significant T2* reduction compared to the other groups (Fig 2; p<0.001). Mean iron content ([Fe]) of Hemo+ on day 56 was 10-fold greater than that observed in control groups (p<0.001), while no differences were observed among the control groups (p=0.14). A strong linear relationship was observed between log(T2*) and -log([Fe]) (R2 = 0.74; p<0.001) on day 56. Conclusion - Hemorrhagic MI leads to chronic iron depositions within the infarct zones. Consequences of chronic iron deposition within the scar tissue remain to be investigated.

Item Type: Article
Uncontrolled Keywords: Cardiac MRI; Myocardial infarction, STEMI; Reperfusion injury
Subjects: Q Science > QA Mathematics > QA75 Electronic computers. Computer science
R Medicine > RC Internal medicine
Research Area: Computer Science and Applications
Depositing User: Users 35 not found.
Date Deposited: 06 Mar 2013 10:56
Last Modified: 12 Mar 2013 09:32
URI: http://eprints.imtlucca.it/id/eprint/1517

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