eprintid: 1517
rev_number: 8
eprint_status: archive
userid: 35
dir: disk0/00/00/15/17
datestamp: 2013-03-06 10:56:25
lastmod: 2013-03-12 09:32:21
status_changed: 2013-03-06 10:56:25
type: article
metadata_visibility: show
creators_name: Kali, Avinash
creators_name: Kumar, Andreas
creators_name: Cokic, Ivan
creators_name: Tsaftaris, Sotirios A.
creators_name: Friedrich, Matthias G
creators_name: Dharmakumar, Rohan
creators_id: 
creators_id: 
creators_id: 
creators_id: sotirios.tsaftaris@imtlucca.it
creators_id: 
creators_id: 
title: Chronic Iron Deposition following Acute Hemorrhagic Myocardial Infarction: A Cardiovascular Magnetic Resonance Study
ispublished: pub
subjects: QA75
subjects: RC
divisions: CSA
full_text_status: none
keywords: Cardiac MRI; Myocardial infarction, STEMI; Reperfusion injury 
abstract: 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. 
date: 2012
date_type: published
publication: Circulation: Cardiovascular Imaging
volume: 126
publisher: American Heart Association
pagerange: A10912
refereed: TRUE
issn: 1941-9651
official_url: http://circ.ahajournals.org/cgi/content/meeting_abstract/126/21_MeetingAbstracts/A10912?sid=3d69db55-f9cf-4ac5-823f-e1066ce04b08
citation:   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)