Detection and characteristics of microvascular obstruction in reperfused acute myocardial infarction using an optimized protocol for contrast-enhanced cardiovascular magnetic resonance imaging.

Published

Journal Article

Several cardiovascular magnetic resonance imaging (CMR) techniques are used to detect microvascular obstruction (MVO) after acute myocardial infarction (AMI). To determine the prevalence of MVO and gain more insight into the dynamic changes in appearance of MVO, we studied 84 consecutive patients with a reperfused AMI on average 5 and 104 days after admission, using an optimised single breath-hold 3D inversion recovery gradient echo pulse sequence (IR-GRE) protocol. Early MVO (2 min post-contrast) was detected in 53 patients (63%) and late MVO (10 min post-contrast) in 45 patients (54%; p = 0.008). The extent of MVO decreased from early to late imaging (4.3±3.2% vs. 1.8±1.8%, p<0.001) and showed a heterogeneous pattern. At baseline, patients without MVO (early and late) had a higher left ventricular ejection fraction (LVEF) than patients with persistent late MVO (56±7% vs. 48±7%, p<0.001) and LVEF was intermediate in patients with early MVO but late MVO disappearance (54±6%). During follow-up, LVEF improved in all three subgroups but remained intermediate in patients with late MVO disappearance. This optimised single breath-hold 3D IR-GRE technique for imaging MVO early and late after contrast administration is fast, accurate and allows detection of patients with intermediate remodelling at follow-up.

Full Text

Duke Authors

Cited Authors

  • Bekkers, SCAM; Backes, WH; Kim, RJ; Snoep, G; Gorgels, APM; Passos, VL; Waltenberger, J; Crijns, HJGM; Schalla, S

Published Date

  • December 2009

Published In

Volume / Issue

  • 19 / 12

Start / End Page

  • 2904 - 2912

PubMed ID

  • 19588152

Pubmed Central ID

  • 19588152

Electronic International Standard Serial Number (EISSN)

  • 1432-1084

Digital Object Identifier (DOI)

  • 10.1007/s00330-009-1489-0

Language

  • eng

Conference Location

  • Germany