Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Magnetic rezonance tomography of the heart with paramagnetic contrast in assessing the inflammatory response of the aortic wall and its biomechanical properties in patients with ischemic myocardial injury

Authors: Fridman A.V.1, Kobelev E.1, Alekseeva Ya.V.2, Minin S.M.1, Nikitin N.A.1, Fridman E.S.1, Bobrikova E.E.1, Ussov W.Yu.1, Chernyavsky A.M.1

Company:
1 National medical research Center named after academician E.N. Meshalkin, Novosibirsk, Russian Federation
2 Cardiothelemetry Center of the L.G. Sokolov North-West District Scientific and Clinical Center, Saint Petersburg, Russian Federation

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DOI: https://doi.org/10.24022/1814-6910-2025-22-1-74-88

UDC: 616.127-005.4-073.756.8

Link: Clinical Physiology of Blood Circulaiton. 2025; 22 (1): 74-88

Quote as: Fridman A.V., Kobelev E., Alekseeva Ya.V., Minin S.M., Nikitin N.A., Fridman E.S., Bobrikova E.E., Ussov W.Yu., Chernyavsky A.M. Magnetic rezonance tomography of the heart with paramagnetic contrast in assessing the inflammatory response of the aortic wall and its biomechanical properties in patients with ischemic myocardial injury. Clinical Physiology of Circulation. 2025; 22 (1): 74–88 (in Russ.). DOI: 10.24022/1814-6910-2025-22-1-74-88

Received / Accepted:  09.01.2025 / 13.02.2025

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Abstract

Aim of the study was to study the complex of visual MR tomographic signs of the process of acute aspetic inflammation of the ascending aortic wall, coronary arteries, infarct-related and noninfarction atherosclerotic plaques, as well as disorders of the mechanical properties of the aorta and indicators of the volume of damage to the heart muscle in acute myocardial infarction, in comparison with patients with chronic postinfarction cardiosclerosis and patients with stable angina without acute myocardial infarction.

Material and methods. The study comprised data from patients (17 in total, 14 men, 59.8 ± 6.95 years old, and 3 women, 63.5 ± 5.7 years old) who were examined in the acute period of myocardial infarction, who underwent successful prehospital thrombolysis with restoration of patency of the infarct-related artery and underwent an autovenous coronary artery bypass surgery (CABG), subsequently successfully performed. As comparison groups, 12 individuals (group 2) who had previously had AMI within 3-4 months and who did not undergo CABG surgery immediately after AMI, and 11 patients (control group 3) who suffered from angina pectoris of functional classes 1-2 without AMI in the anamnesis, at the time of the examination were in stable condition. All patients underwent an MRI scan of the heart and thoracic organs using Philips Brilliance (Philips Medical) and Toshiba Titan Vantage (Toshiba Medical) 1.5 T paramagnetic contrast enhancement (PMCE) MRI scans.

Results. The groups examined in this study, due to their routine clinical selection, did not differ in the magnitude of coronary artery stenosis with atherosclerotic plaque (65-85%). In all cases, the heart attack was a transmural lesion. The values of LVEF in groups 1-3 were, respectively 48,0 ± 6,52 %, 43,5 ± 6,8 %,, 54,3 ± 3,1 %. The indicators of T1-WI intensity enhancement for various anatomical structures with paramagnetic contrast differed most in groups 1-3 in terms of the magnitude of the IE of the coronary artery wall.: 1,62 ± 0,67, 1,25 ± 0,11, 1,21 ± 0,07, respectively, as well as the aortic wall IE: 2.23 ± 0.68, 1.86 ± 0.59 and 1.20 ± 0.09. In patients with initial signs of coronary heart disease, without AMI, group 3 showed no signs of an inflammatory reaction from the aortic wall, in contrast to group 1 and 2. In conditions of inflammatory damage to the aortic wall in AMI, the mechanical extensibility of the aorta was significantly reduced.

Conclusion. Dynamic ECG-synchronized MRI study of the biomechanics and contrast enhancement of the ascending aortic wall is informative in patients with AMI, and makes evidence for the role of aortic volume dilatation reduced by the inflammatory component in the formation of myocardial damage. It is advisable to study the biomechanics of the aorta in the conditions of cardiological departments with the capabilities of ECG – synchronized MRI studies of the heart.

About Authors

  • Alexander V. Friedman, Radiologist; ORCID
  • Evgeny Kobelev, Cand. Med. Sci., Radiologist; ORCID
  • Yana V. Alekseeva, Cand. Med. Sci., Head of the Center for Cardiothelometry; ORCID
  • Stanislav M. Minin, Cand. Med. Sci., Senior Researcher, Head of the Department of Radionuclide Therapy and Diagnostics; ORCID
  • Nikita A. Nikitin, Cand. Med. Sci., Head of the Department of Radiology; ORCID
  • Evgeniya S. Friedman, Ultrasonic and Functional Diagnostician; ORCID
  • Evgeniya E. Bobrikova, Radiologist, Junior Researcher; ORCID
  • Wladimir Yu. Ussov, Dr. Med. Sci., Professor, Chief Researcher; ORCID
  • Alexander M. Chernyavsky, Dr. Med. Sci., Professor, Corresponding Member of the Russian Academy of Sciences, General Director; ORCID

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