Cardiac T1 mapping in non-ST-segment elevation myocardial infarction: temporal changes in myocardial fibrosis

IntroductionCardiac magnetic resonance (CMR) imaging allows tracking of ongoing fibrosis modifications following myocardial infarction (MI). We evaluated temporal changes in late gadolinium enhancement (LGE) and extracellular volume fraction (ECV) within the MI culprit coronary artery and remote reg...

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Main Authors: Luis Paiva, Maria João Ferreira, Sónia Afonso, Paulo Donato, Lino Gonçalves
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1563368/full
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author Luis Paiva
Luis Paiva
Maria João Ferreira
Maria João Ferreira
Maria João Ferreira
Sónia Afonso
Sónia Afonso
Paulo Donato
Paulo Donato
Lino Gonçalves
Lino Gonçalves
author_facet Luis Paiva
Luis Paiva
Maria João Ferreira
Maria João Ferreira
Maria João Ferreira
Sónia Afonso
Sónia Afonso
Paulo Donato
Paulo Donato
Lino Gonçalves
Lino Gonçalves
author_sort Luis Paiva
collection DOAJ
description IntroductionCardiac magnetic resonance (CMR) imaging allows tracking of ongoing fibrosis modifications following myocardial infarction (MI). We evaluated temporal changes in late gadolinium enhancement (LGE) and extracellular volume fraction (ECV) within the MI culprit coronary artery and remote regions of the myocardium during the index ischemic event and follow-up in patients with NSTEMI.MethodsThis prospective, single-center study included 30 patients with type 1 NSTEMI. It involved the evaluation of patients using coronary angiography, invasive coronary physiology, and biomarkers. CMR imaging was used to assess left ventricular (LV) volume, function, and myocardial fibrosis using LGE and ECV. These assessments were performed at baseline and repeated 6-10 months after MI.ResultsAt the 4-year post-MI follow-up, 27 patients survived [age 65 (58,74) years; 77% male], and LV mass, volume, and contractility remained unchanged between the baseline and follow-up measurements. Myocardial fibrosis assessed using LGE showed a decreasing trend at follow-up (9.4 ± 4.4% vs. 6.7 ± 4.4%; p = 0.051), particularly in the MI culprit coronary artery regions (14.2 ± 8.6% vs. 9.5 ± 7.0%; p = 0.015). LGE volume regression was observed in 70% of cases. The ECV measurements did not change between the initial and follow-up CMR assessments. Despite the high prevalence of multivessel coronary artery disease (CAD) (53%), no significant changes in LGE or ECV measurements were observed in the remote myocardium.ConclusionsAfter NSTEMI, LGE decreased in the heart regions supplied by the culprit coronary arteries. However, the ECV measurements remained unchanged. Multivessel CAD was not associated with significant changes in myocardial fibrosis in the remote myocardium.
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spelling doaj-art-eb5963df7d0e45b2b28c0f508a4213702025-08-20T03:13:30ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-05-011210.3389/fcvm.2025.15633681563368Cardiac T1 mapping in non-ST-segment elevation myocardial infarction: temporal changes in myocardial fibrosisLuis Paiva0Luis Paiva1Maria João Ferreira2Maria João Ferreira3Maria João Ferreira4Sónia Afonso5Sónia Afonso6Paulo Donato7Paulo Donato8Lino Gonçalves9Lino Gonçalves10Centro Académico e Clínico de Coimbra (CACC), Coimbra, PortugalCoimbra Institute for Clinical and Biomedical Research (iCBR), Universidade de Coimbra, Coimbra, PortugalCentro Académico e Clínico de Coimbra (CACC), Coimbra, PortugalCoimbra Institute for Biomedical Imaging and Translational Research, Universidade de Coimbra, Coimbra, PortugalInstituto de Ciências Nucleares Aplicadas à Saúde, Universidade de Coimbra, Coimbra, PortugalCoimbra Institute for Biomedical Imaging and Translational Research, Universidade de Coimbra, Coimbra, PortugalInstituto de Ciências Nucleares Aplicadas à Saúde, Universidade de Coimbra, Coimbra, PortugalCentro Académico e Clínico de Coimbra (CACC), Coimbra, PortugalCoimbra Institute for Biomedical Imaging and Translational Research, Universidade de Coimbra, Coimbra, PortugalCentro Académico e Clínico de Coimbra (CACC), Coimbra, PortugalCoimbra Institute for Clinical and Biomedical Research (iCBR), Universidade de Coimbra, Coimbra, PortugalIntroductionCardiac magnetic resonance (CMR) imaging allows tracking of ongoing fibrosis modifications following myocardial infarction (MI). We evaluated temporal changes in late gadolinium enhancement (LGE) and extracellular volume fraction (ECV) within the MI culprit coronary artery and remote regions of the myocardium during the index ischemic event and follow-up in patients with NSTEMI.MethodsThis prospective, single-center study included 30 patients with type 1 NSTEMI. It involved the evaluation of patients using coronary angiography, invasive coronary physiology, and biomarkers. CMR imaging was used to assess left ventricular (LV) volume, function, and myocardial fibrosis using LGE and ECV. These assessments were performed at baseline and repeated 6-10 months after MI.ResultsAt the 4-year post-MI follow-up, 27 patients survived [age 65 (58,74) years; 77% male], and LV mass, volume, and contractility remained unchanged between the baseline and follow-up measurements. Myocardial fibrosis assessed using LGE showed a decreasing trend at follow-up (9.4 ± 4.4% vs. 6.7 ± 4.4%; p = 0.051), particularly in the MI culprit coronary artery regions (14.2 ± 8.6% vs. 9.5 ± 7.0%; p = 0.015). LGE volume regression was observed in 70% of cases. The ECV measurements did not change between the initial and follow-up CMR assessments. Despite the high prevalence of multivessel coronary artery disease (CAD) (53%), no significant changes in LGE or ECV measurements were observed in the remote myocardium.ConclusionsAfter NSTEMI, LGE decreased in the heart regions supplied by the culprit coronary arteries. However, the ECV measurements remained unchanged. Multivessel CAD was not associated with significant changes in myocardial fibrosis in the remote myocardium.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1563368/fullnon-ST-elevation myocardial infarctioncardiac magnetic resonancemappingfollow-upmicrocirculationlate gadolinium enhancement
spellingShingle Luis Paiva
Luis Paiva
Maria João Ferreira
Maria João Ferreira
Maria João Ferreira
Sónia Afonso
Sónia Afonso
Paulo Donato
Paulo Donato
Lino Gonçalves
Lino Gonçalves
Cardiac T1 mapping in non-ST-segment elevation myocardial infarction: temporal changes in myocardial fibrosis
Frontiers in Cardiovascular Medicine
non-ST-elevation myocardial infarction
cardiac magnetic resonance
mapping
follow-up
microcirculation
late gadolinium enhancement
title Cardiac T1 mapping in non-ST-segment elevation myocardial infarction: temporal changes in myocardial fibrosis
title_full Cardiac T1 mapping in non-ST-segment elevation myocardial infarction: temporal changes in myocardial fibrosis
title_fullStr Cardiac T1 mapping in non-ST-segment elevation myocardial infarction: temporal changes in myocardial fibrosis
title_full_unstemmed Cardiac T1 mapping in non-ST-segment elevation myocardial infarction: temporal changes in myocardial fibrosis
title_short Cardiac T1 mapping in non-ST-segment elevation myocardial infarction: temporal changes in myocardial fibrosis
title_sort cardiac t1 mapping in non st segment elevation myocardial infarction temporal changes in myocardial fibrosis
topic non-ST-elevation myocardial infarction
cardiac magnetic resonance
mapping
follow-up
microcirculation
late gadolinium enhancement
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1563368/full
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