Prognostic significance of microvascular obstruction by magnetic resonance imaging in patients with acute myocardial infarction

The extent of microvascular obstruction during acute coronary occlusion may determine the eventual magnitude of myocardial damage and thus, patient prognosis after infarction. By contrast-enhanced MRI, regions of profound microvascular obstruction at the infarct core are hypoenhanced and correspond...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 1998-03, Vol.97 (8), p.765-772
Main Authors: WU, K. C, ZERHOUNI, E. A, JUDD, R. M, LUGO-OLIVIERI, C. H, BAROUCH, L. A, SCHULMAN, S. P, BLUMENTHAL, R. S, LIMA, J. A. C
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Cardiology. Vascular system
Coronary Disease - complications
Coronary Disease - diagnosis
Coronary heart disease
Female
Follow-Up Studies
Heart
Heart Ventricles - pathology
Heart Ventricles - physiopathology
Humans
Magnetic Resonance Imaging
Male
Medical sciences
Microcirculation - pathology
Middle Aged
Myocardial Infarction - complications
Myocardial Infarction - pathology
Prognosis
Severity of Illness Index
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Summary:The extent of microvascular obstruction during acute coronary occlusion may determine the eventual magnitude of myocardial damage and thus, patient prognosis after infarction. By contrast-enhanced MRI, regions of profound microvascular obstruction at the infarct core are hypoenhanced and correspond to greater myocardial damage acutely. We investigated whether profound microvascular obstruction after infarction predicts 2-year cardiovascular morbidity and mortality. Forty-four patients underwent MRI 10 +/- 6 days after infarction. Microvascular obstruction was defined as hypoenhancement seen 1 to 2 minutes after contrast injection. Infarct size was assessed as percent left ventricular mass hyperenhanced 5 to 10 minutes after contrast. Patients were followed clinically for 16 +/- 5 months. Seventeen patients returned 6 months after infarction for repeat MRI. Patients with microvascular obstruction (n = 11) had more cardiovascular events than those without (45% versus 9%; P=.016). In fact, microvascular status predicted occurrence of cardiovascular complications (chi2 = 6.46, P
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.97.8.765