Marc Sirol MD, PhD, Presenter: Nothing to Disclose

Rapahel Dautry MD, Abstract Co-Author: Nothing to Disclose

Damien Logeart, Abstract Co-Author: Nothing to Disclose

Jean-Francois Deux, Abstract Co-Author: Nothing to Disclose

Anthony Dohan MD, Abstract Co-Author: Nothing to Disclose

Elie Mousseaux, Abstract Co-Author: Nothing to Disclose

Helene Vernhet-Kovacsik MD, PhD, Abstract Co-Author: Nothing to Disclose

Herve Pierre Rousseau MD, Abstract Co-Author: Nothing to Disclose

Philippe Alain Soyer MD, PhD, Abstract Co-Author: Research Consultant, Guerbet SA Research Consultant, Ipsen SA

Left ventricular (LV) remodeling associated with low LV ejection fraction following reperfused acute myocardial infarction (AMI), may occur in some patients. We investigated the prognostic value of infarct size (IS), extent of microvascular obstruction (MVO) and intramyocardial hemorrhage (IMH) as assessed by comprehensive cardiovascular magnetic resonance (CMR)

Two hundred patients underwent cardiovascular magnetic resonance at 1.5 Tesla with T2-weighted and T2* imaging and late gadolinium enhancement at 4 days +/-2 and 6 months follow-up following primary percutaneous coronary intervention for AMI. LV remodeling was defined as an increase >20% of left ventricle end-systolic volume (EDV) at follow-up

All patients were analyzed. LV remodeling was observed in 67 patients (33%). 94 patients (47%) presented with Anterior AMI, 46 with Lateral (23%) and 58 with Inferior MI (29%). Mean age was 53+/-11y.o (78% male). Mean delay for reperfusion therapy was 116+/-102min. Despite identical EDV, patients with LV remodeling had lower LVEF at baseline (45%+/-7 vs 51+/-8, p<0.01), a bigger IS (42g+/-20 vs 32g+/-20; p<0.01) and MVO extent (p<0.01). By multivariate analysis, IMH (OR=2.9[1.3-6.3]) and IS (OR=3.1[1.8-12.3]) were identified as independent predictors of LV remodeling.

Presence of IMH assessed by T2* CMR significantly influences LV remodeling. IS and IMH are independent predictors of LV remodeling following reperfused AMI

Despite progresses in reperfusion therapy in acute myocardial infarction, some patients may evolve toward severe heart failure. Cardiac magnetic resonance imaging may be useful in detecting such patients at a very early stage after myocardial reperfusion. Infarct size and presence of intra-myocardial hemorrhage are predictive factors of LV remodeling and adverse cardiovascular events.

Sirol, M, Dautry, R, Logeart, D, Deux, J, Dohan, A, Mousseaux, E, Vernhet-Kovacsik, H, Rousseau, H, Soyer, P, Impact of Intramyocardial Hemorrhage on LV Remodeling in Reperfused Acute Myocardial Infarction.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14017794.html