Aletras, Anthony H

Arai, Andrew E

Booker, O Julian

Greiser, Andreas

Hsu, Li-Yueh

Kellman, Peter

Oki, Abiola J

Ugander, Martin

Zemedkun, Micheas

English

PubMed

Martin Ugander

Micheas Zemedkun

Li-Yueh Hsu

Abiola J Oki

O Julian Booker

Peter Kellman

Andreas Greiser

Anthony H Aletras

Andrew E Arai

Crossref

ORAL PRESENTATION Open AccessNon-contrast quantitative T1-mapping indicatesthat salvaged myocardium develops edemaduring coronary occlusion, whereas infarctionexhibits evidence of additional reperfusion injuryMartin Ugander1*, Micheas Zemedkun1, Li-Yueh Hsu1, Abiola J Oki1, O Julian Booker1, Peter Kellman1,Andreas Greiser2, Anthony H Aletras1, Andrew E Arai1From 2011 SCMR/Euro CMR Joint Scientific SessionsNice, France. 3-6 February 2011IntroductionT2-weighted cardiovascular magnetic resonance (CMR)can characterize myocardial edema in acutely infarctedmyocardium and in recently ischemic but salvaged myo-cardium in ways that are distinct and complementary tolate gadolinium enhanced (LGE) images. If T2 can beused to detect myocardial edema, then non-contrast T1quantification may also be abnormal in a similar fashion.PurposeTo quantitatively assess if salvaged myocardium devel-ops edematous changes during coronary occlusion, butnot reperfusion injury as can be seen in infarction.MethodsDogs (n=9) underwent coronary occlusion and reperfu-sion to delineate the time course of development ofchanges in non-contrast T1 abnormalities. T1 was quan-tified by 1.5T CMR (Siemens) using a Modified Look-Locker Inversion Recovery (MOLLI) sequence. T2-prepared SSFP (T2p) and LGE images were acquired atthe end of the experiment to define 1) Infarction [LGEpositive], 2) Salvaged myocardium [T2p positive andLGE negative] and 3) Remote [T2p and LGE negative].Myocardium which ultimately ended being classifiedinto these three tissue types was identified, and T1 wasquantified over time starting from baseline prior toocclusion.ResultsSee Figure 1. During occlusion, T1 increased in tissuewhich ultimately became Infarction or Salvaged (p<0.01for both), and to a greater extent in tissue which ulti-mately became Infarction compared to Salvaged(p=0.03). Within 30 minutes of reperfusion, T1 ofInfarction increased further (p=0.001), whereas T1 ofSalvaged myocardium remained unchanged after reper-fusion (p=0.73).ConclusionsCoronary occlusion leads to an increase in non-contrastT1, consistent with edema, both in tissue which ulti-mately will become infarcted, and in tissue which1National Institutes of Health, Bethesda, MD, USAFull list of author information is available at the end of the articleFigure 1 Time course of non-contrast T1 values during occlusionand reperfusion for myocardium which ultimately will becomeinfarcted, salvaged and remote.Ugander et al. Journal of Cardiovascular Magnetic Resonance 2011, 13(Suppl 1):O63http://jcmr-online.com/content/13/S1/O63© 2011 Ugander et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative CommonsAttribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction inany medium, provided the original work is properly cited.ultimately will be salvaged. The increase in T1 duringocclusion is more pronounced, consistent with moresevere ischemia, in tissue which ultimately will becomeinfarcted compared to that which becomes salvaged.Following reperfusion, only the tissue which becomesinfarcted, but not that which becomes salvaged,increases additionally in T1, and this is consistent withreperfusion injury in infarcted myocardium.Author details1National Institutes of Health, Bethesda, MD, USA. 2Siemens AG HealthcareSector, Erlangen, Germany.Published: 2 February 2011doi:10.1186/1532-429X-13-S1-O63Cite this article as: Ugander et al.: Non-contrast quantitative T1-mapping indicates that salvaged myocardium develops edema duringcoronary occlusion, whereas infarction exhibits evidence of additionalreperfusion injury. Journal of Cardiovascular Magnetic Resonance 2011 13(Suppl 1):O63.Submit your next manuscript to BioMed Centraland take full advantage of: • Convenient online submission• Thorough peer review• No space constraints or color figure charges• Immediate publication on acceptance• Inclusion in PubMed, CAS, Scopus and Google Scholar• Research which is freely available for redistributionSubmit your manuscript at www.biomedcentral.com/submitUgander et al. Journal of Cardiovascular Magnetic Resonance 2011, 13(Suppl 1):O63http://jcmr-online.com/content/13/S1/O63Page 2 of 2

Journal of Cardiovascular Magnetic Resonance

Non-contrast quantitative T1-mapping indicates that salvaged myocardium develops edema during coronary occlusion, whereas infarction exhibits evidence of additional reperfusion injury

Springer - Publisher Connector

ORAL PRESENTATION Open Access
Non-contrast quantitative T1-mapping indicates
that salvaged myocardium develops edema
during coronary occlusion, whereas infarction
exhibits evidence of additional reperfusion injury
Martin Ugander1*, Micheas Zemedkun1, Li-Yueh Hsu1, Abiola J Oki1, O Julian Booker1, Peter Kellman1,
Andreas Greiser2, Anthony H Aletras1, Andrew E Arai1
From 2011 SCMR/Euro CMR Joint Scientific Sessions
Nice, France. 3-6 February 2011
Introduction
T2-weighted cardiovascular magnetic resonance (CMR)
can characterize myocardial edema in acutely infarcted
myocardium and in recently ischemic but salvaged myo-
cardium in ways that are distinct and complementary to
late gadolinium enhanced (LGE) images. If T2 can be
used to detect myocardial edema, then non-contrast T1
quantification may also be abnormal in a similar fashion.
Purpose
To quantitatively assess if salvaged myocardium devel-
ops edematous changes during coronary occlusion, but
not reperfusion injury as can be seen in infarction.
Methods
Dogs (n=9) underwent coronary occlusion and reperfu-
sion to delineate the time course of development of
changes in non-contrast T1 abnormalities. T1 was quan-
tified by 1.5T CMR (Siemens) using a Modified Look-
Locker Inversion Recovery (MOLLI) sequence. T2-
prepared SSFP (T2p) and LGE images were acquired at
the end of the experiment to define 1) Infarction [LGE
positive], 2) Salvaged myocardium [T2p positive and
LGE negative] and 3) Remote [T2p and LGE negative].
Myocardium which ultimately ended being classified
into these three tissue types was identified, and T1 was
quantified over time starting from baseline prior to
occlusion.
Results
See Figure 1. During occlusion, T1 increased in tissue
which ultimately became Infarction or Salvaged (p<0.01
for both), and to a greater extent in tissue which ulti-
mately became Infarction compared to Salvaged
(p=0.03). Within 30 minutes of reperfusion, T1 of
Infarction increased further (p=0.001), whereas T1 of
Salvaged myocardium remained unchanged after reper-
fusion (p=0.73).
Conclusions
Coronary occlusion leads to an increase in non-contrast
T1, consistent with edema, both in tissue which ulti-
mately will become infarcted, and in tissue which
1National Institutes of Health, Bethesda, MD, USA
Full list of author information is available at the end of the article
Figure 1 Time course of non-contrast T1 values during occlusion
and reperfusion for myocardium which ultimately will become
infarcted, salvaged and remote.
Ugander et al. Journal of Cardiovascular Magnetic Resonance 2011, 13(Suppl 1):O63
http://jcmr-online.com/content/13/S1/O63
© 2011 Ugander et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.
ultimately will be salvaged. The increase in T1 during
occlusion is more pronounced, consistent with more
severe ischemia, in tissue which ultimately will become
infarcted compared to that which becomes salvaged.
Following reperfusion, only the tissue which becomes
infarcted, but not that which becomes salvaged,
increases additionally in T1, and this is consistent with
reperfusion injury in infarcted myocardium.
Author details
1National Institutes of Health, Bethesda, MD, USA. 2Siemens AG Healthcare
Sector, Erlangen, Germany.
Published: 2 February 2011
doi:10.1186/1532-429X-13-S1-O63
Cite this article as: Ugander et al.: Non-contrast quantitative T1-
mapping indicates that salvaged myocardium develops edema during
coronary occlusion, whereas infarction exhibits evidence of additional
reperfusion injury. Journal of Cardiovascular Magnetic Resonance 2011 13
(Suppl 1):O63.
Submit your next manuscript to BioMed Central
and take full advantage of: 
• Convenient online submission
• Thorough peer review
• No space constraints or color figure charges
• Immediate publication on acceptance
• Inclusion in PubMed, CAS, Scopus and Google Scholar
• Research which is freely available for redistribution
Submit your manuscript at 
www.biomedcentral.com/submit
Ugander et al. Journal of Cardiovascular Magnetic Resonance 2011, 13(Suppl 1):O63
http://jcmr-online.com/content/13/S1/O63
Page 2 of 2


Non-contrast quantitative T1-mapping indicates that salvaged myocardium develops edema during coronary occlusion, whereas infarction exhibits evidence of additional reperfusion injury

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