MODERN ASPECTS OF MAGNETIC RESONANCE TOMOGRAPHY IN MYOCARDIAL INFARCTION

Аннотация

According to current clinical guidelines, cardiac magnetic resonance imaging (MRI) is recommended as a key study in the diagnostic algorithm for myocardial infarction, since it allows excluding diseases such as myocarditis, takotsubo syndrome and cardiomyopathy, and also provides visual confirmation of myocardial necrosis. In addition, data are accumulating that support the prognostic value of MRI for this group of patients. This literature review discusses the diagnostic role of MRI in patients with myocardial infarction. Keywords: myocardial infarction, magnetic resonance imaging, pathogenesis, epidemiology. СОВРЕМЕННЫЕ АСПЕКТЫ МАГНИТНО-РЕЗОНАНСНОЙ ТОМОГРАФИИ ПРИ ИНФАРКТЕ МИОКАРДА Арипов Дилшодбек Муродиллоевич https://orcid.org/ 0009-0004-1840-0819 Бухарский государственный медицинский институт имени Абу Али ибн Сино, Узбекистан, г. Бухара. Аннотация Согласно текущим клиническим рекомендациям, магнитно- резонансная томография (МРТ)сердца рекомендуется как ключевое исследование в алгоритме диагностики инфаркт миокарда, так как она позволяет исключить такие заболевания, как миокардит, синдром такоцубо и кардиомиопатии, а также предоставляет визуальное подтверждение миокардиального некроза. Кроме того, накапливаются данные, поддерживающие прогностическую ценность МРТ для этой группы пациентов. Это литературный обзор посвящен обсуждению диагностической роли МРТ у пациентов с инфаркт миокарда. Ключевые слова: инфаркт миокарда, магнитно-резонансная томография, патогенез, эпидемиология. MIOKARD INFARKTIDA MAGNIT-REZONANS TOMOGRAFIYA TEKSHIRUVINING ZAMONAVIY ASPEKTLARI Aripov Dilshodbek Murodilloevich https://orcid.org/ 0009-0004-1840-0819 Abu Ali ibn Sino nomidagi Buxoro davlat tibbiyot instituti, O‘zbekiston, Buxoro. Annotatsiya Mavjud klinik ko'rsatmalarga ko'ra, yurak magnit-rezonans tomografiyasi (MRT) miokard infarkti diagnostikasi algoritmida asosiy tadqiqot sifatida tavsiya etiladi, chunki u miyokardit, takotsubo sindromi va kardiyomiyopatiya https://scientific-jl.com/new 11 22 00 Volume–81_Issue-1_July-2025 JOURNAL OF NEW CENTURY INNOVATIONS kabi kasalliklarni istisno qilishga imkon beradi, shuningdek, miokard nekrozini vizual tasdiqlash imkonini beradi. Bundan tashqari, ushbu bemorlar guruhi uchun MRTning prognostik qiymatini tasdiqlovchi ma'lumotlar to'planmoqda. Ushbu adabiyotlar sharhida miyokard infarkti bo'lgan bemorlarda MRT diagnostik roli muhokama qilinadi. Kalit so'zlar: miokard infarkti, magnit-rezonans tomografiya, patogenez, epidemiologiya. Relevance of the research Non-obstructive myocardial infarction (NOMI) is characterized by the absence of hemodynamically significant stenoses (< 50%) of the coronary arteries (CA) during angiography in patients with myocardial infarction (MI) [1]. The prevalence of Non-obstructive myocardial infarction is 5–6% among patients diagnosed with myocardial infarction; it is higher among women and among patients with non-ST-segment elevation MI (NSTEMI) compared to patients with ST-segment elevation MI (STEMI) [2]. In 2017, the EOC proposed for the first time criteria for the diagnosis of myocardial infarction, which included: 1) verified myocardial infarction, according to the third universal definition; 2) absence of stenosis ≥ 50% of the coronary artery; and 3) absence of another clinically obvious specific cause that could serve as an alternative cause of the acute condition. However, this definition was too broad and included a heterogeneous spectrum of etiologic factors, some of which are not directly related to the development of ischemia [3]. In this regard, in the updated fourth definition of myocardial infarction, structural myocardial changes and extracardiac pathology causing an increase in troponin levels (e.g., myocarditis or pulmonary embolism - PE) are considered separately from myocardial infarction and are designated as "an increase in troponin without coronary artery obstruction". Accordingly, to make a final diagnosis of myocardial infarction, it is necessary to exclude: 1) obvious extracardiac causes of an increase in troponin (e.g., sepsis, PE); 2) ischemic heart disease (IHD) involving small-diameter epicardial vessels (e.g., complete occlusion of a small segment or significant stenosis of the distal branch of the coronary artery ≥ 50%); 3) non-ischemic mechanisms of myocardial injury that mimic MI (e.g., myocarditis, takotsubo syndrome) [2]. According to current clinical guidelines, cardiac magnetic resonance imaging (MRI) is recommended as a key study in the diagnostic algorithm for myocardial infarction, since it can exclude myocarditis, takotsubo syndrome, and cardiomyopathy, and provide imaging confirmation of myocardial necrosis [2, 4, 5]. Currently, more and more data are accumulating indicating the prognostic role of MRI in this category of patients. In rare cases, myocardial infarction may be complicated by the development of left ventricular (LV) maneuvers, LV thrombosis, or life-threatening ventricular arrhythmias [6]. This de