CMR of microvascular obstruction and hemorrhage in myocardial infarction

Research output: Contribution to journalReview article

Abstract

Microvascular obstruction (MO) or no-reflow phenomenon is an established complication of coronary reperfusion therapy for acute myocardial infarction. It is increasingly recognized as a poor prognostic indicator and marker of subsequent adverse LV remodeling. Although MO can be assessed using various imaging modalities including electrocardiography, myocardial contrast echocardiography, nuclear scintigraphy, and coronary angiography, evaluation by cardiovascular magnetic resonance (CMR) is particularly useful in enhancing its detection, diagnosis, and quantification, as well as following its subsequent effects on infarct evolution and healing. MO assessment has become a routine component of the CMR evaluation of acute myocardial infarction and will increasingly play a role in clinical trials of adjunctive reperfusion agents and strategies. This review will summarize the pathophysiology of MO, current CMR approaches to diagnosis, clinical implications, and future directions needed for improving our understanding of this common clinical problem.

Original languageEnglish (US)
Article number68
JournalJournal of Cardiovascular Magnetic Resonance
Volume14
Issue number1
DOIs
StatePublished - Oct 2 2012

Keywords

  • Cardiac magnetic resonance
  • Microvascular obstruction
  • Myocardial hemorrhage
  • Myocardial infarction

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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