Myocardial salvage by T2W-CMR: direct comparison to a non-destructive, high resolution, 3-dimensional ex-vivo assessment of the area at risk simultaneous with infarction

Background The amount of myocardial salvage is a critical determinant of prognosis in acute myocardial infarction (AMI). T2WCMR in combination with DE-CMR is thought to be a promising method that could presumably measure salvage. However, direct comparisons with the appropriate reference standard are limited. Additionally, even if a pathology reference standard is present, co-registration with in-vivo imaging is problematic. We recently validated a new ex-vivo CMR protocol against the reference standard of microspheres and TTC that provides 3D, non-destructive, high-resolution maps of the AAR simultaneously with infarction[1]. Because this map delineates both the AAR and infarction, salvage can be easily measured in a single image, rather than being calculated from 2 datasets. Additionally, the 3D map allows for direct matching of in-vivo DE to ex-vivo CMR and thereby further minimizing the potential for misregistration from in-vivo DE and more importantly in-vivo T2. Therefore, we sought to compare in-vivo calculated salvage to the directly measured salvage by ex-vivo CMR.