The effect of MO on adverse LV remodeling is shown in a patient. CMR-LGE and cine images are shown acutely post-infarction (Panels A & B) and at 9 month follow-up post-infarction (Panels C & D). Despite successful epicardial reperfusion of the left anterior descending coronary artery, there was a large region of persistent MO associated with a large anteroapical infarct measuring 49% of the LV (Panel A). Acutely (Panel B), LVEF measured 27% and LV volumes were enlarged with LV end-diastolic volume (LVEDV) of 192 ml and end-systolic (LVESV) of 141 ml. At 9 month follow-up, there was LV apical aneurysm formation with infarct wall thinning (Panel C) with a persistently reduced LVEF of 25% and further enlargement of the LV with LVEDV of 291 ml and LVESV of 218 ml (Panel D).