Reliability of myocardial salvage assessment by cardiac magnetic resonance imaging in acute reperfused XXXX .

@entity1 @entity296 @entity22740 @entity1188 @entity583
Myocardial salvage assessed by cardiac magnetic resonance imaging (CMRI) holds promise as a surrogate endpoint in studies comparing different treatment strategies for @entity583 ( @entity583 ). The aim of this study was to evaluate the reliability of salvaged myocardium measurements by CMRI. Twenty @entity1 underwent CMRI on 2 consecutive days early after reperfused @entity583 to assess the area at risk (AAR) on T2-weighted and final @entity1188 ( @entity1188 ) on delayed enhancement images. @entity296 ( @entity296 ) was calculated (AAR minus @entity1188 ). Agreement between @entity22740 for the AAR, @entity1188 and @entity296 were analyzed using Bland-Altman analyses. Inter- and intraobserver reliability were assessed. Paired t testing revealed a trend for a significant difference for @entity296 between @entity22740 ( @entity22740 : 43.8      22.5; scan 2: 45.5      22.0; P  =  0.052). The average difference for AAR and @entity1188 between @entity22740 and scan 2 was -0.5 (upper limit of agreement 5.4% of left ventricular [LV] volume; lower limit of agreement -6.4%LV) and 0.1%LV (upper limit of agreement 2.3%LV; lower limit of agreement -2.1%LV). The corresponding calculated @entity296 measurements showed a mean bias of -1.7 (upper limit of agreement 5.5; lower limit of agreement -8.9). Coefficients of repeatability for interobserver variability were 3.6%LV for AAR, 2.4%LV for @entity1188 and 5.4 for @entity296 . Likewise, for intraobserver variability, coefficients of repeatability were 5.0%LV (AAR), 2.4%LV ( @entity1188 ) and 4.8 ( @entity296 ). Assessment of myocardial salvage by CMRI shows acceptable reliability. Further validation studies and trials showing the prognostic value of myocardial salvage by CMRI are needed before routine implementation as a surrogate endpoint in @entity583 trials.
