Detection of myocardial viability based on measurement of sodium content : A 23Na-NMR study

2001 
MRI of total sodium (Na) content may allow assessment of myocardial viability, but information on Na content in normal myocardium, necrotic/scar tissue, and stunned or hibernating myocardium is lacking. Thus, the aims of the study were to: 1) quantify the temporal changes in myocardial Na content post-myocardial infarction (MI) in a rat model (Protocol 1); 2) compare Na in normally perfused, hibernating, and stunned canine myocardium (Protocol 2); and 3) determine whether, in buffer-perfused rat hearts, infarct scar can be differentiated from intact myocardium by 23Na-MRI (Protocol 3). In Protocol 1, rats were subjected to LAD ligation. Infarct/scar tissue was excised at control and 1, 3, 7, 28, 56, and 128 days post-MI (N = 6–8 each), Na content was determined by 23Na-NMR spectroscopy (MRS) and ion chromatography. Na content was persistently increased at all time points post-MI averaging 306*–160*% of control values (*P < 0.0083 vs. control). In Protocol 2, 23Na-MRS of control (baseline), stunned and hibernating samples revealed no difference in Na. In Protocol 3, 23Na-MRI revealed a mean increase in signal intensity, to 142 ± 6% of control values, in scar tissue. A threshold of 2 standard deviations of the image intensity allowed determination of infarct size, correlating with histologically determined infarct size (r = 0.91, P < 0.0001). Magn Reson Med 45:756–764, 2001. © 2001 Wiley-Liss, Inc.
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