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

Research output: Contribution to journalArticle

Abstract

Background - 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. Methods and Results - 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 (χ2=6.46, P2=5.17, P2=10.0, P

Original languageEnglish (US)
Pages (from-to)765-772
Number of pages8
JournalCirculation
Volume97
Issue number8
StatePublished - Mar 3 1998

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Myocardial Infarction
Infarction
Magnetic Resonance Imaging
Coronary Occlusion
Morbidity
Injections
Mortality

Keywords

  • Magnetic resonance imaging
  • Microcirculation
  • Prognosis

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Prognostic significance of microvascular obstruction by magnetic resonance imaging in patients with acute myocardial infarction",
abstract = "Background - 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. Methods and Results - 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 (χ2=6.46, P2=5.17, P2=10.0, P",
keywords = "Magnetic resonance imaging, Microcirculation, Prognosis",
author = "Wu, {Katherine Chih-Ching} and Elias Zerhouni and Judd, {Robert M.} and Lugo-Olivieri, {Carlos H.} and Lili Barouch and Schulman, {Steven P} and Blumenthal, {Roger S} and Joao Lima",
year = "1998",
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pages = "765--772",
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T1 - Prognostic significance of microvascular obstruction by magnetic resonance imaging in patients with acute myocardial infarction

AU - Wu, Katherine Chih-Ching

AU - Zerhouni, Elias

AU - Judd, Robert M.

AU - Lugo-Olivieri, Carlos H.

AU - Barouch, Lili

AU - Schulman, Steven P

AU - Blumenthal, Roger S

AU - Lima, Joao

PY - 1998/3/3

Y1 - 1998/3/3

N2 - Background - 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. Methods and Results - 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 (χ2=6.46, P2=5.17, P2=10.0, P

AB - Background - 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. Methods and Results - 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 (χ2=6.46, P2=5.17, P2=10.0, P

KW - Magnetic resonance imaging

KW - Microcirculation

KW - Prognosis

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