In patients, early after acute myocardial infarction (AMI), rapid magnetic resonance
imaging (MRI) techniques have been used to assess left ventricular (LV) structure,
global and regional function, infarct artery patency, or contrast uptake individually.
We hypothesized that MRI could be used as a comprehensive evaluation of the post-AMI
patient, studying all of these parameters in < 1 hour. Twenty-seven patients were
studied after first AMI. Complete examinations were performed in 23 patients, 16 with
anterior and 7 with inferior wall myocardial infarction, on day 5 +/- 2 after the
event. For measurement of LV structure and regional function, a breath-hold segmented
k-space gradient echo tagging sequence was used. A fat-suppressed segmented k-space
breath-hold sequence was used for coronary artery imaging. MRI contrast-enhanced images
during bolus gadoteridol transit through the myocardium were obtained to assess first-pass
contrast uptake. No adverse events were noted during the MRI scanning, which was completed
in 46 +/- 5 minutes. The LV mass index, end-diastolic and end-systolic volume indexes,
and ejection fraction were (mean +/- SD) 107 +/- 13 g/m2, 87 +/- 23 ml/m2, 54 +/-
20 ml/m2, and 39 +/- 12%, respectively. Intramyocardial percent circumferential shortening
was 11 +/- 6% at the apex, 14 +/- 4% in the midventricle, and 15 +/- 4% at the base.
Flow within all infarct arteries was visualized. Seventeen of 23 patients had regions
of reduced contrast uptake on first-pass imaging with mean signal intensity of 47
+/- 24% that of remote regions. In patients with recent AMI, comprehensive assessment
of LV structure and function, infarct artery patency, and regional myocardial contrast
uptake was safe and feasible with MRI of < 1 hour.