TY  - JOUR
ID  - eprints1517
VL  - 126
Y1  - 2012///
KW  - Cardiac MRI; Myocardial infarction
KW  -  STEMI; Reperfusion injury 
AV  - none
TI  - Chronic Iron Deposition following Acute Hemorrhagic Myocardial Infarction: A Cardiovascular Magnetic Resonance Study
JF  - Circulation: Cardiovascular Imaging
UR  - http://circ.ahajournals.org/cgi/content/meeting_abstract/126/21_MeetingAbstracts/A10912?sid=3d69db55-f9cf-4ac5-823f-e1066ce04b08
PB  - American Heart Association
SN  - 1941-9651
A1  - Kali, Avinash
A1  - Kumar, Andreas
A1  - Cokic, Ivan
A1  - Tsaftaris, Sotirios A.
A1  - Friedrich, Matthias G
A1  - Dharmakumar, Rohan
N2  - 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. 
ER  -