Experimental validation of contrast-enhanced SSFP cine CMR for quantification of myocardium at risk in acute myocardial infarction

Background: accurate assessment of myocardium at risk (mar) after acute myocardial infarction (ami) is necessary when assessing myocardial salvage. contrast-enhanced steady-state free precession (ce-ssfp) is a recently developed cardiovascular magnetic resonance (cmr) method for assessment of mar up to 1 week after ami. our aim was to validate ce-ssfp for determination of mar in an experimental porcine model using myocardial perfusion single-photon emission computed tomography (mps) as a reference standard and to test the stability of mar-quantification over time after injecting gadolinium-based contrast. methods: eleven pigs were subjected to either 35 or 40 min occlusion of the left anterior descending artery followed by six hours of reperfusion. a technetium-based perfusion tracer was administered intravenously ten minutes before reperfusion. in-vivo and ex-vivo ce-ssfp cmr was performed followed by ex-vivo mps imaging. mar was expressed as % of left ventricular mass (lvm). results: there was good agreement between mar by ex-vivo cmr and mar by mps (bias: 1 ± 3% lvm,r 2 = 0.92,p < 0.001),between ex-vivo and in-vivo cmr (bias 0 ± 2% lvm,r 2 = 0.94,p < 0.001) and between in-vivo cmr and mps (bias -2 ± 3% lvm,r 2 = 0.87,p < 0.001. no change in mar was seen over the first 30 min after contrast injection (p = 0.95). conclusions: contrast-enhanced ssfp cine cmr can be used to measure mar,both in vivo and ex vivo,in a porcine model with good accuracy and precision over the first 30 min after contrast injection. this offers the option to use the less complex ex-vivo imaging when determining myocardial salvage in experimental studies. © 2017 the author(s).