Fig. 3
A patient with a proximal LAD infarct receiving standard STEMI treatment. a, balanced steady state free precession (bSSFP) end-diastolic images with endo- and epi-cardial contours. The patient developed adverse left ventricular (LV) remodeling (defined as ≥ 20% increase in LV end-diastolic volume (LVEDV) and had a slight reduction in LV ejection fraction (LVEF) at 6 months after STEMI. b, T2-weighted short tau inversion recovery (STIR) images, showing the presence of edema (white arrows) and intramyocardial hemorrhage (IMH) (yellow arrowheads) at 1-week after STEMI. c, late gadolinium enhancement (LGE) images, showing the presence of acute ischemic injury (white arrows) with microvascular obstruction (MVO, yellow arrowheads) at 1 week after STEMI and infarct scar (white arrows) at 6-months. d, end-systolic bSSFP images with feature-tracking circumferential LV strain overlay. At 6 months the infarct zone circumferential strain improved despite the presence of a huge infarct with IMH and MVO in the acute phase, while the remote zone strain slightly declined bSSFP, balanced steady state free precession; ED, end-diastolic; ES, end-systolic; IMH, intramyocardial hemorrhage; LAD, left anterior descending coronary artery, LGE, late gadolinium enhancement; LV, left ventricular; LVEDV, left ventricular end-diastolic volume; LVEF, left ventricular ejection fraction; MVO, microvascular obstruction; SSFP, steady-state free precession; STEMI, ST-segment elevation myocardial infarction; STIR, short tau inversion recovery.