title: Sequelae of acute myocardial infarction regarding cardiac structure and function and their prognostic significance as assessed by magnetic resonance imaging.
abstract: OBJECTIVE
  Because of its high spatial resolution and tissue contrast, magnetic resonance imaging (MRI) was used to assess cardiac structure and function in a large population of patients with acute myocardial infarction (AMI).
  
  
  RESULTS
  One hundred and ten patients were studied by MRI 6.1 +/- 2.2 days after AMI. Infarct size (IS), persistent microvascular obstruction (PMO), left and right ventricular (LV/RV) volumes, and functions were measured. The same MRI measurements were repeated in 89 patients after a mean follow-up period of 225 +/- 92 days. IS was 11.9 +/- 7.3% of total LV muscle mass. PMO was detected in 51/110 (46.4%) patients and comprised 15.6 +/- 8.5% of IS and 2.8 +/- 2.3% of LV muscle mass. Papillary muscle infarct was seen in 26%, RV infarction in 16%, pericarditis in 40%, and pericardial effusion in 66% of the patients. During follow-up, there were 16 major adverse cardiac events (MACE) including seven deaths. IS, PMO, and amount of transmural infarction were predictive for LV adverse remodelling defined as > 20% increase in LV end-diastolic volume. Multivariable analysis revealed LV end-diastolic volume, LV ejection fraction, and PMO as significant predictors for the occurrence of MACE.
  
  
  CONCLUSIONS
  MRI is a highly sensitive and reliable tool to detect morphologic and functional sequelae of AMI providing baseline MRI parameters with relevant predictive power for LV adverse remodelling and occurrence of MACE.
authors.affiliation: Department of Internal Medicine II-Cardiology, University of Ulm, Robert-Koch-Strasse 8, D-89081 Ulm, Germany. vinzenz.hombach@medizin.uni-ulm.de
authors.forename: Vinzenz
authors.initials: V
authors.lastname: Hombach
authors.forename: Olaf
authors.initials: O
authors.lastname: Grebe
authors.forename: Nico
authors.initials: N
authors.lastname: Merkle
authors.forename: Sebastian
authors.initials: S
authors.lastname: Waldenmaier
authors.forename: Martin
authors.initials: M
authors.lastname: Höher
authors.forename: Matthias
authors.initials: M
authors.lastname: Kochs
authors.forename: Jochen
authors.initials: J
authors.lastname: Wöhrle
authors.forename: Hans A
authors.initials: HA
authors.lastname: Kestler
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D011379:Prognosis; D012044:Regression Analysis; D012307:Risk Factors; D020257:Ventricular Remodeling