Magnetic resonance imaging quantification of left ventricular dysfunction following coronary microembolization

Area of Science:

• Cardiovascular Imaging
• Interventional Cardiology
• Cardiac MRI

Background:

• Microembolization is a frequent complication following coronary interventions.
• Assessing its impact on left ventricular (LV) function is crucial for patient outcomes.

Purpose of the Study:

• To quantify the effects of coronary microembolization on LV function using Magnetic Resonance Imaging (MRI).
• To evaluate changes in LV volumes, ejection fraction, strain, and viability post-microembolization.

Main Methods:

• Eight pigs underwent selective left anterior descending artery (LAD) catheterization for MR contrast and embolic agent delivery.
• Cine, tagged, and delayed contrast-enhanced MRI (DCE-MRI) were performed at baseline, 1 hour, and 1 week.
• Histopathology confirmed microinfarction extent and characteristics.

Main Results:

• Microembolization led to a persistent decline in ejection fraction and increased LV end-diastolic and end-systolic volumes.
• Dysfunctional regions were observed in the microembolized LAD territory for up to 1 week.
• Histopathology confirmed microinfarction with ongoing tissue repair, showing LV dysfunction disproportionate to the damage size.

Conclusions:

• Coronary microembolization causes significant and persistent LV dysfunction.
• MRI effectively visualizes microinfarction and quantifies its impact on cardiac mechanics and geometry.
• Findings highlight the clinical relevance of microembolic events in coronary interventions.