The relationship of structural changes in the wall of the ascending aorta and myocardium according to chest contrast-enhanced MRI in myocardial infarction patients

Abstract

Aim. Pathological accumulation of contrast-paramagnetic by the aortic wall interrelated with volume of ischemic myocardial infarction damage and left ventricular ejection fraction (EFLV) were studied in patients with acute myocardial infarction (AMI). Materials and Methods. By contrast-enhanced MRI (CE-MRI) and quantitative methods of image processing left ventricular mass (ММLV) and mass of myocardial damage (МDAMI) were calculated. 25 patients having AMI within 2–4,5 weeks (19 male, 6 female, age 60.6±3.8 years), 12 patients with stable angina without AMI (7 male, 5 female, age 57.6±3.3 years) and 11 practically healthy people without heart disease (6 male, 5 female, age 63.1±3.2 years) were studied. Results. Paramagnetic contrast enhancement of the aortic wall was found to be significantly correlated with severity of infarction damage (the index (МDAMI/ММLV))). Enhancement index T1-WI of the aortic wall less than 1.18–1.20 means that only 2 of 10 patients had myocardial damage higher 20 % (i. e., (МDAMI/ММLV)>0.2); the index greater than 1.20 means 10 of 15 patients had the damage (p<0.02). Furthermore, the proportion of the damaged myocard (МDAMI/ММLV) was found to be related with left ventricular ejection fraction (EFLV). When (МDAMI/ММLV) ranged in 0.2–0.25, the EFLV per normal value was slightly decreased; when higher the upper limit EFLV sharply decreased and achieved 20–35 % when LV myocardium had more than third of damage. Conclusion. Mechanisms of the damage of aortic wall and functioning of the ascending aorta faced to risk of myocardial infarction should be studied along with coronary and myocardial pathology.><0.02). Furthermore, the proportion of the damaged myocard (МDAMI/ММLV) was found to be related with left ventricular ejection fraction (EFLV). When (МDAMI/ММLV) ranged in 0.2–0.25, the EFLV per normal value was slightly decreased; when higher the upper limit EFLV sharply decreased and achieved 20–35 % when LV myocardium had more than third of damage. Conclusion. Mechanisms of the damage of aortic wall and functioning of the ascending aorta faced to risk of myocardial infarction should be studied along with coronary and myocardial pathology.