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Impact of intramyocardial hemorrage on LV remodeling after ST-elevation myocardial infarction


Left ventricle (LV) remodeling associated with lower LV ejection fraction after successfully treated ST-elevation myocardial infarction (STEMI) may occur in some patients. We investigated the prognostic value of intramyocardial hemorrhage (IMH) as assessed by T2* images beyond a comprehensive CMR assessment with late gadolinium enhancement (LGE) imaging including microvascular obstruction (MVO) evaluation.


A total of 110 patients with STEMI were prospectively recruited and were examined with CMR at Day 4 ± 2 and Month 6 after reperfusion for measurement of LV end-diastolic (EDV) and end-systolic (ESV) volumes, LV ejection fraction (LVEF) infarct size (IS) and presence and extent of MVO and IMH. Adverse remodeling was defined as dilated left ventricular end-systolic volume indexes (EDV) at 6 months CMR.


All patients were analysed. 41 patients (45%) presented with Anterior AMI, 26 with Lateral (23%) and 29 with Inferior MI (32%). Mean age was 54 +/- 12 y.o (75% male). Mean delay for reperfusion therapy was 115 +/- 100 min. LV remodelling was observed in 39 patients (36%). Despite identical EDV, patients with LV remodelling had lower LVEF at baseline (45% +/- 7 vs 51 +/- 8, p < 0.01), a bigger IS (42 g +/- 20 vs 32 +/- 20; p < 0.01) and MVO extent (p < 0.01). By multivariate analysis, IMH (OR = 2.8[1.3-6.0]) and IS (OR = 3.2[1.8-12.5]) were identified as independent predictors of LV remodelling.


Presence of IMH after STEMI assessed by T2* CMR predicts LV adverse remodeling.


Research Grant from the french Society of cardiology (SFC)

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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Sirol, M., Gzara, H., Logeart, D. et al. Impact of intramyocardial hemorrage on LV remodeling after ST-elevation myocardial infarction. J Cardiovasc Magn Reson 16 (Suppl 1), P103 (2014).

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