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MRI demonstrates a decrease in myocardial infarct healing and increase in compensatory ventricular hypertrophy

Hisham Z Bajwa1, Loi Do, Mohammed Suhail

  • 1Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA.

Journal of Magnetic Resonance Imaging : JMRI
|January 23, 2014
PubMed
Summary
This summary is machine-generated.

Mechanical obstruction of microvessels (MVO) hinders heart attack healing and worsens left ventricular (LV) remodeling. This MRI study shows MVO significantly impairs infarct resorption and increases adverse LV changes over time.

Keywords:
MRIcardiac functioncardiac hypertrophycoronary interventionsmyocardial infarct healing

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Area of Science:

  • Cardiovascular Research
  • Medical Imaging
  • Regenerative Medicine

Background:

  • Myocardial infarction (heart attack) healing is crucial for recovery.
  • Microvascular obstruction (MVO) is a known complication after reperfusion injury.
  • The precise impact of MVO on infarct resorption and left ventricular (LV) remodeling remains under investigation.

Purpose of the Study:

  • To provide direct evidence using MRI that mechanical obstruction of microvessels inhibits infarct resorption (healing).
  • To demonstrate that MVO enhances adverse left ventricular (LV) remodeling.
  • To investigate the relationship between MVO extent and LV functional and structural changes.

Main Methods:

  • Pigs underwent LAD occlusion/reperfusion or occlusion/microemboli/reperfusion.
  • Cardiac MRI (cine and DE-MRI) assessed LV function, mass, infarct size, and MVO.
  • Imaging was performed at 3 days and 5 weeks post-intervention.

Main Results:

  • Persistent MVO was larger and more frequent in the microemboli group (Group III) compared to the control group (Group II).
  • Patchy microinfarcts at infarct borders were observed in Group III due to microembolization.
  • Group III showed greater reduction in ejection fraction and increase in LV volumes, indicating more significant adverse remodeling.

Conclusions:

  • Microvascular obstruction (MVO) significantly delays or inhibits infarct resorption (healing).
  • MVO accentuates left ventricular (LV) hypertrophy and pathological remodeling post-myocardial infarction.
  • MRI is a valuable tool for assessing MVO and its consequences on cardiac healing and remodeling.