Cardiovascular magnetic resonance of myocardial viability

Abstract

Ischemic heart disease remains the leading cause of morbidity and mortality in the Western world. Ischemic cardiomyopathy is a frequent cause of chronic heart failure and has become a major problem in clinical cardiology. In recent years, magnetic resonance imaging (MRI) has been applied increasingly, in the evaluation of patients with CAD. A comprehensive cardiac MRI study including assessment of myocardial perfusion, myocardial function, both at rest and under stress, and delayed contrast-enhancement for myocardial viability imaging, and coronary magnetic resonance angiography for detecting stenosis can now be performed in a relatively short time. Therefore, MRI can be used to evaluate most aspects of the ischemic cascade. Moreover, MRI provides additional information for the surgeon needed to select the optimal surgical strategy, for instance including information on left and right ventricular function, the presence of aneurysms and ischemic mitral regurgitation. The aim of this thesis was to evaluate magnetic resonance imaging (MRI) techniques for the assessment of myocardial viability in patients with acute and chronic myocardial infarction. In addition, remodeling of the ventricles was investigated and evaluated.