Peri-infarct edema leads to overestimation of myocardial salvage in late reperfused myocardial infarction

Background In patients with acute myocardial infarction (AMI) the myocardial salvage index (MSI) quantified by Cardiovascular Magnetic Resonance (CMR) is defined as the volumetric difference of myocardial edema, reflecting the perfusion bed, and the infarcted tissue. While after a coronary occlusion time of more than 8 hours, relevant myocardial salvage is highly unlikely, previous data however showed myocardial edema surrounding the infarcted tissue after prolonged occlusion times. We therefore speculated that peri-infarct edema can be consistently observed in very late reperfused MI, indicating that edema in late reperfused MI does not necessarily reflect myocardial salvage.