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Imaging technique predicts success of bypass surgery or angioplasty

CHICAGO --- An advance in magnetic resonance imaging (MRI) developed by researchers at Northwestern University Medical School and Siemens Medical Systems has radically improved the ability to determine which patients with coronary artery disease will benefit from bypass surgery or angioplasty.

The investigators, led by Northwestern cardiologist Raymond J. Kim, M.D., and basic scientist Robert M. Judd, used an improved version of a technique known as contrast-enhanced MRI in 50 patients with heart disease who were scheduled to have bypass surgery or coronary angioplasty.

As reported in an article in the Nov. 16 issue of The New England Journal of Medicine, the scientists found that contrast-enhanced MRI boosted image intensity by 10-fold over previous methods and enabled the researchers without stress testing or use of radioactive tracers -- to distinguish between reversible and irreversible heart injury.

Drs. Kim and Judd explained that with this technique, heart regions damaged by heart attack or other coronary artery disease appear on MRI as hyperenhanced, or "bright."

The researchers found that areas of the heart that were "dark" on the MRI recovered following bypass surgery or angioplasty, whereas "bright" areas did not recover after surgery.

The research group, which consisted of cardiologists, basic scientists and physicists, also reported that contrast-enhanced MRI is the first technique to allow physicians to view the extent of damage within the heart wall following a heart attack.

The wall of the heart is approximately 10 millimeters thick. In a heart attack, the cells in the inner part of the heart wall die first and the damage progresses outward.

"We found that heart muscle function at the injury site was more and more likely not to improve as the extent of bright areas increased through the wall of the heart," Kim said.

The ability to look at damage within the wall of the heart is possible because
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Contact: Elizabeth Crown
e-crown@northwestern.edu
312-503-8928
Northwestern University
14-Nov-2000


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