The Measurement of Acute Myocardial Infarct Size by CT

  • Bruce H. Brundage
Part of the Acute Coronary Care Updates book series (ACCU, volume 1)

Abstract

Over the past 15 years clinicians have been challenged by the idea that patients with acute myocardial infarction could have myocardium saved if treatment was initiated soon enough.(1) This concept that myocardium destined to become necrotic could be salvaged is still controversial.(2) Many reports have suggested a variety of medications to reduce myocardial oxygen consumption or increase coronary perfusion at the borders of the evolving infarction.(3–6) More recently, the rediscovery that myocardial infarction is often precipitated by an acute thrombosis of a coronary artery has stimulated the use of thrombolytic agents to dissolve the thrombus and reestablish perfusion in the occluded vessel.(7) However, in spite of more than a decade of investigations evaluating the effects of these many therapies, there is still significant controversy about the effectiveness of any of these agents.(8) A major reason for the continuing confusion is the lack of a satisfactory method for accurately measuring the amount of infarcted myocardium and judging the quantity of jeopardized myocardium that is potentially salvageable. In a recent review of infarct limiting therapy, Mueller and Braunwald state “the assessment of the efficacy of therapeutic intervention has been greatly hampered by the absence of a direct method of determining infarct size in patients with nonfatal myocardial infarction. In addition to identifying salvage of myocardium, it is helpful not only to measure but also to predict how large the infarction would have been had the intervention not been applied. Such predictions are difficult, if not impossible, in the clinical situation at the present time.”(9)

Keywords

Attenuation Creatinine Iodine Shrinkage Cardiol 

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Copyright information

© Martinus Nijhoff Publishing, Boston 1985

Authors and Affiliations

  • Bruce H. Brundage
    • 1
  1. 1.The Cardiology Section, Department of MedicineUniversity of Illinois at ChicagoUSA

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