Vol. 30 No. 1 (2026)
CORONARY ARTERY DISEASES

The role of magnetic resonance imaging in the diagnosis of post-infarction left ventricular aneurysms: a single-center prospective observational study

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  • Alexander M. Chernyavskiy ,
  • Maria A. Moskovskih,
  • Andrey V. Protopopov,
  • Sergey E. Khrushchev,
  • Dmitry A. Sirota
Alexander M. Chernyavskiy
Meshalkin National Medical Research Center, Ministry of Health of the Russian Federation, Novosibirsk State Medical University
Maria A. Moskovskih
State Budget Healthcare Institution of the Novosibirsk Region, Outpatient Diagnostic Clinic No. 2, Novosibirsk, Russian Federation
Andrey V. Protopopov
Meshalkin National Medical Research Center, Ministry of Health of the Russian Federation
Sergey E. Khrushchev
Sobolev Institute of Mathematics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation
Dmitry A. Sirota
Meshalkin National Medical Research Center, Ministry of Health of the Russian Federation, Novosibirsk State Medical University
DOI: https://doi.org/10.21688/1681-3472-2026-1-55-66

Published 2026-04-14

Keywords

  • cardiac magnetic resonance imaging; diagnostic performance; left ventricular aneurysm

How to Cite

Chernyavskiy , A. M., Moskovskih, M. A., Protopopov, A. V., Khrushchev, S. E. K., & Sirota, D. A. (2026). The role of magnetic resonance imaging in the diagnosis of post-infarction left ventricular aneurysms: a single-center prospective observational study. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 30(1), 55–66. https://doi.org/10.21688/1681-3472-2026-1-55-66

Copyright (c) 2026 Chernyavskiy et al.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Introduction. Magnetic resonance imaging allows for the assessment of overall and regional myocardial contractility of the left ventricle, and the use of contrast enhancement evaluates the depth of wall damage, which together serve as important prognostic criteria for the improvement of myocardial contractile function in the postoperative period.

Objective. To determine the diagnostic capabilities of magnetic resonance imaging in post-infarction cardiac aneurysms.

Methods. For inclusion in the prospective observational study, 160 patients with post-infarction heart aneurysms were assessed. Preoperative modeling of the left ventricle cavity was performed on all patients.

Results. Magnetic resonance imaging reliably detects a greater number of segments with impaired kinetic function compared to echocardiography. In the assessment of local contractility using delayed contrast enhancement, a higher number of segments with impaired kinetics were identified. On average, each patient had 4.40 ± 0.95 segments with abnormal kinetics. The average difference in the number of segments amounted to 68 segments [60; 87]. A negative correlation was observed between the depth of myocardial damage and the type of local contractility impairment: as the transmurality index increased, the number of segments with hypokinesis decreased (r = –0.74; p = 0.032), while the number of segments with akinesis increased (r = 0.82; p = 0.026). In terms of diagnostic performance, MRI demonstrated superior sensitivity and specificity for diagnosing postinfarction left ventricular aneurysm, with values of 97.6 % and 100 %, respectively, compared to echocardiography, which had sensitivity and specificity values of 68.5 % and 8.3 %, respectively.

Conclusion. Magnetic resonance imaging reliably detects a greater number of segments with impaired kinetic function compared to echocardiography. It allows for the reliable detection of a greater number of segments with kinetic impairment compared to echocardiography. The use of MRI with delayed contrast enhancement increases the informativeness of the method. This technique is safe and does not increase hospital mortality.

Received 27 December 2024. Revised 8 May 2025. Accepted 24 November 2025.

Informed consent
The patient’s informed consent to use the records for medical purposes is obtained.

Funding

The participation of S. Khrushchev was supported by the Program for Fundamental Scientific Research of the Siberian Branch of the Russian Academy of Sciences (project FWNF-2024-0001). The funders had no role in the study design, data collection and analysis, decision to publish, or manuscript preparation.

Conflict of interest
The authors declare no conflict of interest.

Contribution of the authors

Conception and study design: A.M. Chernyavskiy, M.A. Moskovskih

Data collection and analysis: M.A. Moskovskih

Statistical analysis: S.E. Khrushchev

Drafting the article: M.A. Moskovskih Critical revision of the article: M.A. Moskovskih, A.V. Protopopov, D.A. Sirota Final approval of the version to be published: all authors

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References

  1. Богачев-Прокофьев А.В., Сапегин А.В., Караськов А.М. Состояние и перспективы развития кардиохирургической помощи в Сибирском федеральном округе. Патология кровообращения и кардиохирургия. 2017;21(4),13–18. http://dx.doi.org/10.21688/1681-3472-2017-4-13-18 Bogachev-Prokophiev A.V., Sapegin A.V., Karaskov A.M. Cardiac surgery in Siberia: present and perspectives. Patologiya krovoobrashcheniya i kardiokhirurgiya = Circulation Pathology and Cardiac Surgery. 2017;21(4):13-18. (In Russ.) http://dx.doi.org/10.21688/1681-3472-2017-4-13-18
  2. Богопольская О.М. Вторичная профилактика сердечно-сосудистых осложнений после аортокоронарного шунтирования. Кардиология и сердечно-сосудистая хирургия. 2007;1:52-56. Bogopolskaya O.M. Secondary prevention of cardiovascular complications after coronary artery bypass surgery. Journal of Cardiology and Cardiovascular Surgery. 2007;1:52-56. (In Russ.)
  3. Бокерия Л.А., Гудкова Р.Г. Сердечно-сосудистая хирургия – 2014. Болезни и врожденные аномалии системы кровообращения. М.: Изд-во НЦССХ им. А.Н. Бакулева РАМН, 2015. 220 с. Bockeria L.A., Gudkova R.G. Cardiovascular surgery – 2014. Diseases and congenital anomalies of the circulatory system. Moscow: Publishing house of the Scientific Center for Cardiovascular Surgery named after A.N. Bakuleva Russian Academy of Medical Sciences, 2015. (In Russ.)
  4. Лыков Р.А., Кранин Д.Л., Замский К.С., Федорова Н.И., Михеев А.А. Хирургическое лечение пациентов с постинфарктными аневризмами левого желудочка сердца, осложненными тромбозом. Вестн. НМХЦ им. Н.И. Пирогова. 2013;8(2):7-9. Lykov R.A., Kranin D.L., Zamskij K.S., Fedorova N.I., Miheev A.A. Surgical theatment of patients with left ventricular aneurysm, assotiated with clot. Bulletin of Pirogov National Medical & Surgical Center. 2013;8(2):7-9. (In Russ.)
  5. Сумин А.В., Деветьярова Е.А., Поддубный А.В., Дюжиков А.А. Хирургическая коррекция постинфарктной аневризмы левого желудочка у пациентов молодого возраста. Грудная и сердечно-сосудистая хирургия. 2018;60(3):210-216. https://doi.org/10.24022/0236-2791-2018-60- 3-210-216 Sumin A.V., Devet’yarova E.A., Poddubnyy A.V., Dyuzhikov A.A. Surgical correction of postinfarction left ventricular aneurysm in a young patient. Journal of Thoracic and Cardiovascular Surgery. 2018; 60 (3):210-216. (In Russ.) https://doi.org/10.24022/0236-2791-2018-60-3-210-216
  6. Алшибая М.Д., Сливнева И.В., Амирбеков М.М., Чеишвили З.М., Лагутина О.С. Геометрическая реконструкция левого желудочка при тромбозе латеральной стенки. Патология кровообращения и кардиохирургия. 2020;24(3):121-131. http://dx.doi.org/10.21688/1681-3472-2020-3-121-131 Alshibaya M.D., Slivneva I.V., Amirbekov M.M., Cheishvili Z.M., Lagutina O.S. Geometric reconstruction of the left ventricle in lateral wall thrombosis. Patologiya krovoobrashcheniya i kardiokhirurgiya = Circulation Pathology and Cardiac Surgery. 2020;24(3):121- 131. (In Russ.) http://dx.doi.org/10.21688/1681-3472-2020-3-121-131
  7. Гришин И.Р., Акчурин Р.С., Ширяев А.А. Непосредственные результаты аневризмэктомии в сочетании с эндовентрикулопластикой в лечении больных ишемической болезнью сердца с постинфарктной аневризмой левого желудочка. Грудная и сердечно-сосудистая хирургия. 2008;1:28-31. Grishin I.R., Akchurin R.S., Shiryaev A.A. Immediate results of aneurysmectomy in combination with endoventriculoplasty in the treatment of patients with coronary heart disease with post-infarction left ventricular aneurysm. Thoracic and cardiovascular surgery. 2008;1:28-31. (In Russ.)
  8. Живоглядов Д.И., Шария М.А. Лучевые методы оценки перфузии миокарда. Росс. электрон. журн. лучевой диагностики. 2014;4(4):59-66. Zhivoglyadov D.I., Sharia M.A. Radiological examination in the evaluation of myocardial perfusion. Russian electronic journal of radiology. 2014;4(4):59-66. (In Russ.)
  9. Gutberlet M., Spors B., Thoma T., Bertram H., Denecke T., Felix R., Noutsias M., Schultheiss H.P., Kühl U. Suspected chronic myocarditis at cardiac MR: diagnostic accuracy and association with immunohistologically detected inflammation and viral persistence. Radiology. 2008;246(2):401-9. PMID: 18180335. https://doi.org/10.1148/radiol.2461062179
  10. Röttgen R., Christiani R., Freyhardt P., Gutberlet M., Schultheiss H.P., Hamm B., Kühl U. Magnetic resonance imaging findings in acute myocarditis and correlation with immunohistological parameters. Eur Radiol. 2011;21(6):1259-1266. PMID: 21116631; PMCID: PMC3088804. https://doi.org/10.1007/s00330-010-2022-1
  11. Kramer C.M., Barkhausen J., Bucciarelli-Ducci C., Flamm S.D., Kim R.J., Nagel E. Standardized cardiovascular magnetic resonance imaging (CMR) protocols: 2020 update. J Cardiovasc Magn Reson. 2020;22(1):17. PMID: 32089132; PMCID: PMC7038611. https://doi.org/10.1186/s12968-020-00607-1
  12. Никифоров В.С. Методы сердечно-сосудистой визуализации в диагностике ишемической болезни сердца. Consilium Medicum. 2017;19(1):18-24. Nikiforov V.S. Methods of cardiovascular imaging for the detection of ischemic heart disease. Consilium Medicum. 2017;19(1):18-24. (In Russ.)
  13. Усов В.Ю., Вышлов Е.В., Беличенко О.И., Мочула О.В., Алексеева Я.В., Ярошевский С.П., Рябов В.В., Лукьянёнок П.И., Марков В.А. Магнитно-резонансная томография с парамагнитным контрастным усилением в раннем контроле состояния миокарда пациентов с острым инфарктом после тромболитической терапии и стентирования. Терапевт. 2018;1-2:54-66. Ussov W.Yu., Vyshlov E.V., Belichenko O.I., Mochula O.V., Alekseeva Ya.V., Yaroshevskij S.P., Ryabov V.V., Luk’yanyonok P.I., Markov V.A. Contrast-enhanced magnetic resonance imaging in early quantification of efficiencyof coronary thrombolytic and intraarterial stent therapy of acute myocardial infarction. Therapist. 2018;1-2:54-66. (In Russ.)
  14. Рустамова Я.К. Актуальные вопросы диагностики жизнеспособного миокарда. Кардиология. 2019;59(2):68-78. https://doi.org/10.18087/cardio.2019.2.10243 Rustamova Y.K. Actual Problems of Diagnostics of Viable Myocardium. Kardiologiia. 2019;59(2):68-78. (In Russ.) PMID: 30853023. https://doi.org/10.18087/cardio.2019.2.10243
  15. Patel H., Mazur W., Williams K.A. Sr, Kalra D.K. Myocardial viability – State of the art: Is it still relevant and how to best assess it with imaging? Trends Cardiovasc Med. 2018;28(1):24-37. PMID: 28735783. https://doi.org/10.1016/j.tcm.2017.07.001
  16. Чернявский А.М., Караськов А.М., Марченко А.В., Хапаев С.А. Реконструктивная хирургия постинфарктных аневризм левого желудочка. Новосибирск: Изд-во СО РАН, фил. «Гео», 2003. Chernyavsky A.M., Karaskov A.M., Marchenko A.V., Khapaev S.A. Reconstructive surgery of post- infarction left ventricular aneurysms. Novosibirsk: Publishing house of the Siberian branch of the Russian Academy of Sciences, “Geo”, 2003. (In Russ.)
  17. Cerqueira M.D., Weissman N.J., Dilsizian V., Jacobs A.K., Kaul S., Laskey W.K., Pennell D.J., Rumberger J.A., Ryan T., Verani M.S.; American Heart Association Writing Group on Myocardial Segmentation and Registration for Cardiac Imaging. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation. 2002;105(4):539-42. PMID: 11815441. https://doi.org/10.1161/hc0402.102975
  18. De Cobelli F., Pieroni M., Esposito A., Chimenti C., Belloni E., Mellone R., Canu T., Perseghin G., Gaudio C., Maseri A., Frustaci A., Del Maschio A. Delayed gadolinium-enhanced cardiac magnetic resonance in patients with chronic myocarditis presenting with heart failure or recurrent arrhythmias. J Am Coll Cardiol. 2006;47(8):1649-54. PMID: 16631005. https://doi.org/10.1016/j.jacc.2005.11.067
  19. Mahrholdt H., Goedecke C., Wagner A., Meinhardt G., Athanasiadis A., Vogelsberg H., Fritz P., Klingel K., Kandolf R., Sechtem U. Cardiovascular magnetic resonance assessment of human myocarditis: a comparison to histology and molecular pathology. Circulation. 2004;109(10):1250-8. PMID: 14993139. https://doi.org/10.1161/01.CIR.0000118493.13323.8
  20. Mahrholdt H., Wagner A., Deluigi C.C., Kispert E., Hager S., Meinhardt G., Vogelsberg H., Fritz P., Dippon J., Bock C.T., Klingel K., Kandolf R., Sechtem U. Presentation, patterns of myocardial damage, and clinical course of viral myocarditis. Circulation. 2006;114(15):1581-90. PMID: 17015795. https://doi.org/10.1161/CIRCULATIONAHA.105.606509
  21. McCrohon J.A., Moon J.C., Prasad S.K., McKenna W.J., Lorenz C.H., Coats A.J., Pennell D.J. Differentiation of heart failure related to dilated cardiomyopathy and coronary artery disease using gadolinium-enhanced cardiovascular magnetic resonance. Circulation. 2003;108(1):54-9. PMID: 12821550. https://doi.org/10.1161/01.CIR.0000078641.19365.4C
  22. Windecker S., Kolh P., Alfonso F., Collet J.P., Cremer J., Falk V., Filippatos G., Hamm C., Head S.J., Jüni P., Kappetein A.P., Kastrati A., Knuuti J., Landmesser U., Laufer G., Neumann F.J., Richter D.J., Schauerte P., Sousa Uva M., Stefanini G.G., Taggart D.P., Torracca L., Valgimigli M., Wijns W., Witkowski A. 2014 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J. 2014;(35):2541-619. https://doi.org/10.1093/eurheartj/ehu278
  23. Беловолова Е.В., Терентьев В.П., Кучеренко О.Б., Собин С.В., Кудрявцева Н.Ю., Джемакулов Я.К. Диагностическая значимость магнитно-резонансной томографии при поражении миокарда различного генеза. Медицинский вестник Юга России. 2018;9(3):65-69. https://doi.org/10.21886/2219-8075-2018-9-3-65-69 Belovolova Е.V., Terentev V.P., Kucherenko O.B., Sobin S.V., Kudryavtseva N.Yu., Dzhemakulov Ja.K. Diagnostic significance of magnetic resonance imaging for myocardial damage of various genesis. Medical Herald of the South of Russia. 2018;9(3):65-69. (In Russ.) https://doi.org/10.21886/2219-8075-2018-9-3-65-69
  24. Юрпольская Л.А., Макаренко В.Н., Бокерия Л.А. МРТ сердца с контрастированием: альтернативный или необходимый диагностический модуль в кардиологической и кардиохирургической практике. Лучевая диагностика и терапия. 2015;6(3):5-14. Yurpolskaya L.A., Makarenko V.N., Bokeria L.A. Cardiac MRI with contrast enhancement: an alternative or a necessary diagnostic module in cardiology practice. Diagnostic radiology and radiotherapy. 2015;6(3):5-14. (In Russ.)
  25. Усов В.Ю., Архангельский В.А., Федоренко Е.В. Оценка жизнеспособности поврежденного миокарда у кардиохирургических больных: сравнение возможностей магнитно-резонансной и эмиссионной томографии. Комплексные проблемы сердечно-сосудистых заболеваний. 2014(3):124-133. https://doi.org/10.17802/2306-1278-2014-3-124-133 Usov W.Yu., Arkhangelsky V.A., Fedorenko E.V. Detection of myocardial viability in isсhaemic damage in cardiac surgery: comparison of possibilities of magnetic resonance and emission tomography. Complex Issues of Cardiovascular Diseases. 2014;(3):124-133. (In Russ.) https://doi.org/10.17802/2306-1278-2014-3- 124-133
  26. Железняк И.С., Труфанов Г.Е., Рудь С.Д., Меньков И.А., Романов Г.Г., Краковская К.А. Магнитно- резонансная томография в диагностике ишемической болезни сердца. Клиническая медицина: Научно-практический журнал. 2013;91(5):72-74. Zheleznyak I.S., Trufanov G.E., Rud’ S.D., Men’kov I.A., Romanov G.G., Krakovskaya K.A. Magnetic resonance tomography in diagnostics of coronary heart disease. Clinical Medicine. 2013;91(5):72-74. (In Russ.)
  27. Железняк И.С., Труфанов Г.Е., Рудь С.Д., Меньков И.А., Романов Г.Г., Краковская К.А. МРТ- семиотика ишемической болезни сердца. Лучевая диагностика и терапия. 2013;4(4):73-77. Zheleznyak I.S., Trufanov G.E., Rud’ S.D., Men’kov I.A., Romanov G.G., Krakovskaya K.A. MRI semiotics of coronary artery disease. Diagnostic radiology and radiotherapy. 2013;4(4):73-77. (In Russ.)