Cardiovascular magnetic resonance imaging protocol
Cardiovascular MRI was performed at 5 ± 2 days and 103 ± 11 days after admission. Images were acquired on a 1.5-T MRI system (Intera, Philips Medical Systems, Best, The Netherlands) with a dedicated five-element phased array surface coil. For functional analysis, ECG-gated cine images were obtained in the LV short axis plane covering the entire LV using a segmented balanced steady-state free precession sequence [slice thickness 6 mm, slice gap 4 mm, average repetition time (TR) and echo time (TE) 3.8/1.9 ms, respectively, flip angle 50°, FOV 350 mm, matrix 256 × 256, typically 22–25 phases per cardiac cycle]. Next, a breath-hold, multislice, black blood T2-weighted turbo spin-echo sequence with short inversion time and fat suppression was used (T2 STIR, slice thickness 8 mm, slice gap 2 mm, TR two R-R intervals and TE 100 ms, FOV 350 mm, matrix 512 × 512). LGE CMR was performed 10 min after an intravenous bolus of 0.2 mmol/kg body weight gadolinium-diethylenetriaminepentaacetic acid (Magnevist®, Bayer Schering Pharma, Berlin, Germany) using a breath-hold three-dimensional inversion-recovery gradient-echo sequence [acquired slice thickness 12 mm, reconstructed slice thickness 6 mm, average TR/TE 3.9/2.4 ms, multi-shot (50 profiles/shot) segmented partial echo readout every heart beat (TFE), flip angle 15°, FOV 400 mm, matrix 256 × 256, acquired and reconstructed pixel size 1.56 × 1.56 mm]. The inversion time that optimally suppressed signal of non-infarcted myocardium (typical range 200–280 ms) was determined with a preceding Look-Locker sequence.