Scar tissue on contrast-enhanced MRI predicts left ventricular remodelling after acute infarction

Coronary artery disease is the leading cause of death in the Western world, and the annual incidence of acute myocardial infarction (AMI) in the US is 865 000.1 A substantial percentage of patients develop left ventricular dilatation (remodelling) after AMI, resulting in heart failure, which is associated with high morbidity and mortality. Aggressive medical treatment may prevent or halt left ventricular dilatation, and early, accurate identification of patients at risk for left ventricular dilatation is essential. Quantification of infarct size may be useful for identification of patients after AMI at risk for left ventricular dilatation. Contrast-enhanced MRI is a reliable and reproducible technique that allows precise quantification of the amount of scar tissue2,3; moreover, the spatial resolution of MRI allows delineation of the transmurality of the infarction. Accordingly, the value of contrast-enhanced MRI to predict left ventricular dilatation after AMI was evaluated in a consecutive cohort of patients after AMI. The study population consisted of 29 consecutive patients with a first AMI, documented by typical chest pain lasting >30 min, raised concentration of creatine kinase-MB protein and/or troponin …