Cardiac MRI Endpoints in Myocardial Infarction Experimental and Clinical Trials,Journal of the American College of Cardiology

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Cardiac MRI Endpoints in Myocardial Infarction Experimental and Clinical Trials
Journal of the American College of Cardiology ( IF 21.7 ) Pub Date : 2019-07-01 , DOI: 10.1016/j.jacc.2019.05.024
Borja Ibanez ₁ , Anthony H Aletras ₂ , Andrew E Arai ₃ , Hakan Arheden ₄ , Jeroen Bax ₅ , Colin Berry ₆ , Chiara Bucciarelli-Ducci ₇ , Pierre Croisille ₈ , Erica Dall'Armellina ₉ , Rohan Dharmakumar ₁₀ , Ingo Eitel ₁₁ , Rodrigo Fernández-Jiménez ₁₂ , Matthias G Friedrich ₁₃ , David García-Dorado ₁₄ , Derek J Hausenloy ₁₅ , Raymond J Kim ₁₆ , Sebastian Kozerke ₁₇ , Christopher M Kramer ₁₈ , Michael Salerno ₁₈ , Javier Sánchez-González ₁₉ , Javier Sanz ₂₀ , Valentin Fuster ₂₀

Affiliation

Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; CIBERCV, Madrid, Spain; Cardiology Department, IIS Fundación Jiménez Díaz Hospital, Madrid, Spain.
Laboratory of Computing, Medical Informatics and Biomedical-Imaging Technologies, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece; Lund University, Department of Clinical Sciences Lund, Clinical Physiology, Skane University Hospital, Lund, Sweden.
National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
Lund University, Department of Clinical Sciences Lund, Clinical Physiology, Skane University Hospital, Lund, Sweden.
Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Leiden, the Netherlands.
British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, and Golden Jubilee National Hospital, Clydebank, United Kingdom.
Bristol Heart Institute, Bristol NIHR Cardiovascular Research Centre, University of Bristol and University Hospitals Bristol NHS Trust, Bristol, United Kingdom.
University Lyon, UJM-Saint-Etienne, INSA, CNRS UMR 5520, INSERM U1206, CREATIS, F-42023, Saint-Etienne, France.
Leeds Institute of Cardiovascular and Metabolic Medicine, Department of Biomedical Imaging Sciences, University of Leeds, Leeds, United Kingdom.
Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, and Division of Cardiology, Department of Medicine, University of California, Los Angeles, California.
University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine) and German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany.
Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; CIBERCV, Madrid, Spain; Cardiology Department, Icahn School of Medicine at Mount Sinai, New York, New York.
Departments of Medicine & Diagnostic Radiology, McGill University, Montreal, Quebec, Canada; Department of Medicine, Heidelberg University, Heidelberg, Germany.
CIBERCV, Madrid, Spain; Vall d'Hebron University Hospital and Research Institute, Universtat Autònoma de Barcelona, Barcelona, Spain.
Cardiovascular & Metabolic Disorders Program, Duke-National University of Singapore Medical School, National Heart Research Institute Singapore, National Heart Centre, Yong Loo Lin School of Medicine, National University Singapore, Singapore; The Hatter Cardiovascular Institute, University College London, and The National Institute of Health Research University College London Hospitals Biomedical Research Centre, Research & Development, London, United Kingdom; Tecnologico de Monterrey, Centro de Biotecnologia-FEMSA, Nuevo Leon, Mexico.
Duke Cardiovascular Magnetic Resonance Center, Division of Cardiology, and Department of Radiology, Duke University Medical Center, Durham, North Carolina.
Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland.
Departments of Medicine and Radiology, University of Virginia Health System, Charlottesville, Virginia.
Philips Healthcare, Madrid, Spain.
Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Cardiology Department, Icahn School of Medicine at Mount Sinai, New York, New York.

After a reperfused myocardial infarction (MI), dynamic tissue changes occur (edema, inflammation, microvascular obstruction, hemorrhage, cardiomyocyte necrosis, and ultimately replacement by fibrosis). The extension and magnitude of these changes contribute to long-term prognosis after MI. Cardiac magnetic resonance (CMR) is the gold-standard technique for noninvasive myocardial tissue characterization. CMR is also the preferred methodology for the identification of potential benefits associated with new cardioprotective strategies both in experimental and clinical trials. However, there is a wide heterogeneity in CMR methodologies used in experimental and clinical trials, including time of post-MI scan, acquisition protocols, and, more importantly, selection of endpoints. There is a need for standardization of these methodologies to improve the translation into a real clinical benefit. The main objective of this scientific expert panel consensus document is to provide recommendations for CMR endpoint selection in experimental and clinical trials based on pathophysiology and its association with hard outcomes.

中文翻译：

心肌梗塞实验和临床试验中的心脏 MRI 终点

再灌注心肌梗死 (MI) 后，会发生动态组织变化（水肿、炎症、微血管阻塞、出血、心肌细胞坏死，并最终被纤维化替代）。这些变化的范围和程度有助于心肌梗死后的长期预后。心脏磁共振 (CMR) 是无创心肌组织表征的金标准技术。CMR 也是在实验和临床试验中识别与新的心脏保护策略相关的潜在益处的首选方法。然而，实验和临床试验中使用的 CMR 方法存在广泛的异质性，包括 MI 后扫描的时间、采集协议，以及更重要的是终点的选择。需要对这些方法进行标准化，以更好地转化为真正的临床效益。这份科学专家小组共识文件的主要目标是根据病理生理学及其与硬结果的关联，为实验和临床试验中的 CMR 终点选择提供建议。

更新日期：2019-07-01

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