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Background  To investigate the influence of cardiovascular magnetic resonance (CMR) timing after reperfusion on CMR-derived parameters of ischemia/reperfusion (I/R) injury in patients with ST-segment elevation myocardial infarction (STEMI).    Methods  The study included 163 reperfused STEMI patients undergoing CMR during the index hospitalization. Patients were divided according to the time between revascularization and CMR (T revasc-CMR : Tertile-1 ≤ 43; 43 < Tertile-2 ≤ 93; Tertile-3 > 93 h). T2-mapping derived area-at-risk (AAR) and intramyocardial-hemorrhage (IMH), and late gadolinium enhancement (LGE)-derived infarct size (IS) and microvascular obstruction (MVO) were quantified. T1-mapping was performed before and > 15 min after Gd-based contrast-agent administration yielding extracellular volume (ECV) of infarct.    Results  Main factors influencing I/R injury were homogenously balanced across T revasc-CMR  tertiles. T2 values of infarct and remote regions increased with increasing T revasc-CMR  tertiles (infarct: 60.0 ± 4.9 vs 63.5 ± 5.6 vs 64.8 ± 7.5 ms;  P  < 0.001; remote: 44.3 ± 2.8 vs 46.1 ± 2.8 vs ± 46.1 ± 3.0;  P  = 0.001). However, T2 value of infarct largely and significantly exceeded that of remote myocardium in each tertile yielding comparable T2-mapping-derived AAR extent throughout T revasc-CMR  tertiles (17 ± 9% vs 19 ± 9% vs 18 ± 8% of LV, respectively,  P  = 0.385). Similarly, T2-mapping-based IMH detection and quantification were independent of T revasc-CMR . LGE-derived IS and MVO were not influenced by T revasc-CMR  (IS: 12 ± 9% vs 12 ± 9% vs 14 ± 9% of LV, respectively,  P  = 0.646). In 68 patients without MVO, T1-mapping based ECV of infarct region was comparable across T revasc-CMR  tertiles ( P  = 0.470).    Conclusion  In STEMI patients, T2 values of infarct and remote myocardium increase with increasing CMR time after revascularization. However, these changes do not give rise to substantial variation of T2-mapping-derived AAR size nor of other CMR-based parameters of I/R.    Trial registration   ISRCTN03522116 . Registered 30.4.2018 (retrospectively registered).

journal of cardiovascular magnetic resonance

Relationship between CMR-derived parameters of ischemia/reperfusion injury and the timing of CMR after reperfused ST-segment elevation myocardial infarction