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European Heart Journal 2004 25(23):2173; doi:10.1016/j.ehj.2004.08.028
Copyright © 2004 by the European Society of Cardiology.
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Letter to the Editor

Myocardial infarction after coronary revascularization: role of cardiovascular magnetic resonance oedema imaging

Johnny Steuera,* and Tomas Bjernerb

a Department of Cardiothoracic Surgery, University Hospital, SE-751 85 Uppsala, Sweden
b Department of Diagnostic Radiology, University Hospital, SE-751 85 Uppsala, Sweden

* Tel.: +46 18 6114040; fax: +46 18 551526 (E-mail: johnny.steuer{at}surgsci.uu.se).

Dear Editor,

We find the recent study by Abdel-Aty et al. [1] very interesting and we thank them for their comment. In our study [2], we applied strict criteria in order to exclude patients with previous myocardial infarctions. The finding that the higher the biochemical marker level the greater the amount of infarcted tissue, supported our assumption of a causal connection between peri-operative myocardial infarction and post-operative elevation of biochemical markers. However, contrast-enhanced magnetic resonance imaging may distinguish between viable and non-viable regions throughout infarct healing [3], but does not differentiate between acute and chronic infarction [4]. Since not all patients with previous infarctions have a history of myocardial infarction or evidence of infarction on the ECG, echocardiography or ventriculography, we believe that the newly described imaging approach [1] may be a valuable contribution for the future assessment of patients with elevated cardiac markers after coronary revascularization.

References

  1. Abdel-Aty H, Zagrosek A, Schulz-Menger J, et al. Delayed enhancement and T2-weighted cardiovascular magnetic resonance imaging differentiate acute from chronic myocardial infarction Circulation 2004;109:2411-2416.[Abstract/Free Full Text]
  2. Steuer J, Bjerner T, Duvernoy O, et al. Visualisation and quantification of peri-operative myocardial infarction after coronary artery bypass surgery with contrast-enhanced magnetic resonance imaging Eur Heart J 2004;25:1293-1299.[Abstract/Free Full Text]
  3. Fieno DS, Kim RJ, Chen EL, et al. Contrast-enhanced magnetic resonance imaging of myocardium at risk: distinction between reversible and irreversible injury throughout infarct healing J Am Coll Cardiol 2000;36:1985-1991.[Abstract/Free Full Text]
  4. Kim RJ, Fieno DS, Parrish TB, et al. Relationship of MRI delayed contrast enhancement to irreversible injury, infarct age, and contractile function Circulation 1999;100:1992-2002.[Abstract/Free Full Text]

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