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Size of myocardial infarct measured using MRI

arying strengths of a computer model called full-width at half-maximum. This computer method calculates the amount of damaged tissue by comparing MRI signal strength between damaged and undamaged tissue. Damaged heart tissue is denser than undamaged tissue because the muscle structure has collapsed, and MRI can distinguish between tissues of varying density.

The results of each method were then compared against precise measurements at autopsy. The size of an m.i. was measured as a percentage of left ventricular volume. All measurements using MRI were taken within 24 hours after heart attack to simulate "real life" conditions.

Results showed that the full-width-at-half-maximum method was superior to all other methods, at 94 percent accuracy, when the least strict computer modeling formula was used, set at only one standard deviation between density of damaged and undamaged tissue. Other, stricter formulas in current use were accurate to 85 percent or less, if at all. When visual cues, the most commonly used method, were used, infarct size was measured with 69 percent accuracy.

"Our hope is that these results will help establish clear and effective guidelines for measuring the size of an m.i., and this will improve a physician's ability to make an accurate prognosis," said lead study author and Hopkins cardiology research fellow Luciano Amado, M.D. "Cardiologists also need to accurately gauge the amount of damaged muscle as part of our preparations for future treatments that could possibly repair it, most notably stem cell therapies."

This six-month study was conducted between December 2001 and June 2002, with funding provided by the National Institutes of Health and Datascope Corp. Other Hopkins investigators involved in this research were Bernhard Gerber, M.D.; Gilberto Szarf, M.D.; Khurram Nasir, M.D., Ph.D.; and Dara Kraitchman, V.M.D., Ph.D., who helped design the study. Additional assistance was provided by Dan Rettm
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Contact: David March
dmarch1@jhmi.edu
410-955-1534
Johns Hopkins Medical Institutions
20-Dec-2004


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