title: Effect of microvascular obstruction and intramyocardial hemorrhage by CMR on LV remodeling and outcomes after myocardial infarction: a systematic review and meta-analysis.
abstract: The goal of this systematic analysis is to provide a comprehensive review of the current cardiac magnetic resonance data on microvascular obstruction (MVO) and intramyocardial hemorrhage (IMH). Data related to the association of MVO and IMH in patients with acute myocardial infarction (MI) with left ventricular (LV) function, volumes, adverse LV remodeling, and major adverse cardiac events (MACE) were critically analyzed. MVO is associated with a lower ejection fraction, increased ventricular volumes and infarct size, and a greater risk of MACE. Late MVO is shown to be a stronger prognostic marker for MACE and cardiac death, recurrent MI, congestive heart failure/heart failure hospitalization, and follow-up LV end-systolic volumes than early MVO. IMH is associated with LV remodeling and MACE on pooled analysis, but because of limited data and heterogeneity in study methodology, the effects of IMH on remodeling require further investigation.
authors.affiliation: Cardiovascular Division, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia.
authors.forename: Yasmin S
authors.initials: YS
authors.lastname: Hamirani
authors.affiliation: University of Virginia School of Medicine, Charlottesville, Virginia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Wong
authors.affiliation: Cardiovascular Division, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia; Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, Virginia.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Kramer
authors.affiliation: Cardiovascular Division, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia; Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, Virginia. Electronic address: ms5pc@virginia.edu.
authors.forename: Michael
authors.initials: M
authors.lastname: Salerno
mesh_terms: D000818:Animals; D016009:Chi-Square Distribution; D003326:Coronary Circulation; D006333:Heart Failure / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology*; D006470:Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008833:Microcirculation; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D009206:Myocardium / Q000473:pathology*; D054318:No-Reflow Phenomenon / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
keywords: cardiac magnetic resonance; ejection fraction; intramyocardial hemorrhage; left ventricular remodeling; microvascular obstruction