ORIGINAL PAPER Myocardial strain in sub-acute peri-infarct myocardium Bala ´zs Ruzsics Æ Pa ´l Sura ´nyi Æ Pa ´l Kiss Æ Brigitta C. Brott Æ Silvio Litovsky Æ Thomas S. Denney Jr. Æ Inmaculada Aban Æ Steven G. Lloyd Æ Tamas Simor Æ Gabriel A. Elgavish Æ Himanshu Gupta Received: 27 November 2007 / Accepted: 14 August 2008 / Published online: 15 October 2008 Ó Springer Science+Business Media, B.V. 2008 Abstract Purpose In the absence of additional ischemic insults, the peri-infarct region surrounding the infarct myocardium can recover function. T2 weighted MRI signal is sensitive to edema and used to detect peri-infarct, salvageable myocardium. The main purpose of this study was to investigate the alterations in myocardial strain in the peri-infarct myocardium as compared to normal and infarct myocardium. Materials and methods Comprehensive MRI of the myocardium was performed in five pigs 6–7 days following coronary artery occlusion–reper- fusion myocardial injury. MRI included tagged cine images for myocardial strain, T2weighted (T2w)- images and late gadolinium enhancement (LGE) for assessing myocardial viability. Automated signal intensity thresholds were used to define tissue edema and myocardial infarct. Maximum-shortening strains were analyzed in the infarct, peri-infarct and normal myocardial sectors. The results were corre- lated with triphenyltetrazolium-chloride (TTC) and hemotoxylin–eosin stained tissue images. Results We found an excellent correlation of LGE with TTC (r = 0.94, P \ 0.05). T2w-images markedly over- estimated the infarct size (25 ± 3%). Both the healthy and peri-infarct myocardial sectors had higher myocardial strain than infarct myocardial sectors (P \ 0.05). Clear demarcation between infarct and non-infarct myocardium was noted on histology. Conclusion Peri-infarct myocardium con- tinues to demonstrate T2 signal enhancement to at least 7 days, but this region has preserved mechan- ical function. T2-weighted imaging and myocardial strain measurements provide complementary infor- mation and both may be useful for characterization of the peri-infarct myocardium. Keywords Peri-infarct myocardium Á Magnetic resonance imaging Á Myocardial strain Á Delayed enhancement Á Myocardial perfusion Bala ´zs Ruzsics and Pa ´l Sura ´nyi have contributed equally. B. Ruzsics Á P. Sura ´nyi Á P. Kiss Á T. Simor Á G. A. Elgavish Department of Biochemistry and Molecular Genetics, University of Alabama, Birmingham, AL, USA B. C. Brott Á S. G. Lloyd Á G. A. Elgavish Á H. Gupta (&) Department of Medicine, Division of Cardiovascular Disease, CVMRI, University of Alabama, BDB 101, 1808 7th Avenue South, Birmingham, AL 35294, USA e-mail: hgupta@cardmail.dom.uab.edu S. Litovsky Department of Anatomic Pathology, University of Alabama, Birmingham, AL, USA T. S. Denney Jr. Department of Electrical and Computer Engineering, Auburn University, Auburn, AL, USA I. Aban Department of Biostatistics, University of Alabama, Birmingham, AL, USA 123 Int J Cardiovasc Imaging (2009) 25:151–159 DOI 10.1007/s10554-008-9364-7