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Myocardial change with microvasculer obstruction after acute myocardial infarction


Microvascular obstruction detected by Cardiovascular Magnetic Resonance (CMR) has been linked to ventricular remodeling and adverse cardiovascular events in acute myocardial infarction (AMI).


We analyzed how the changes of myocardium with MVO in human reperfused myocardium affect left ventricular function by using two imaging modalities, CMR and cardiac nuclear imaging.


We investigated 28 patients with anterior AMI in whom primary percutaneous coronary intervention was performed successfully (mean age : 63.4 +- 8.4 year old, female 14.3%). From nuclear imaging, ejection fraction (LVEF), left ventricular volumes, and summed defect score (SDS) 2 weeks and 3 months post-MI were obtained by using rest gated technetium-99 m tetrofosmin electrocardiography-gated single photon emission computed tomography. Gdlinium contrast enhancement CMR imaging was performed within 2 weeks after AMI using a 1.5 T imaging unit. The patient's characteristics and cardiac parameters were compared between two groups: with MVO (group M, n = 18) and without MVO (group nM, n = 10).


Both groups had similar baseline characteristics about coronary risk factors. In group M, peak CK was higher (7208 IU/L and 3929 IU/L, P < 0.01) and reperfusion time was shorter (4.7 hr and 3.7 hr, P < 0.01) tnan group nM. Left ventricular end-diastolic volume (LVEDV) (142 ml and 134 ml, P < 0.01) and SDS (33 and 20, p < 0.05) showed significantly larger in early phase of AMI in group M. Although LVEDV at three months after AMI kept larger value (149 ml and 128 ml, p < 0.01) in group M, LVEF weren't different in each group. The improvement of LVEF was also remarkably larger in group M (21% and 9%). Any medication such as beta blocking agents and angiotensin converting enzyme inhibitors didn't affect these results. See Table 1.

Table 1 Cardiac performance


Although MVO detected by CMR predict the ventricular remodeling even in successful coronary intervention, this adaptation is thought to increase cardiac output to some extent.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Yasuyo, T., Ishimoto, T., Yamada, S. et al. Myocardial change with microvasculer obstruction after acute myocardial infarction. J Cardiovasc Magn Reson 11 (Suppl 1), P266 (2009).

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