الفهرس 
Radiological Anatomy and Orientation of the HeartOnly 14 pages are availabe for public view
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Abstract
Background: Reperfusion therapy in patients with acute myocardial infarction (AMI) can salvage the myocardium, however, successful restoration of the coronary artery patency is not always associated with adequate perfusion at the level of microvasculature, known as the no-reflow or microvascular occlusion (MVO). The primary objective of our prospective study was to assess, by cardiac MRI, the prognostic value of MVO’s size and its impact on left ventricular (LV) remodeling in cases of reperfused AMI.
33 patients with AMI underwent cardiac MRI at 1.5 T scanner within 7 days (baseline) and 3 months (follow-up) after reperfusion. Patients with MVO were included where early gadolinium enhancement (EGE), late gadolinium enhancement (LGE) and cine sequences were acquired. The impact of MVO size on LV ejection fraction (EF%) and LV volumes was quantitively analyzed.
Results: There was a significant inverse correlation between the MVO size % of the LV mass (LVM) and the EF% values measured at follow-up with p-value of 0.000 while a significant positive correlation was encountered between the MVO% of LVM and both indexed end-systolic volume (ESVI) and indexed end-diastolic volume (EDVI) values measured at follow-up with p values of 0.438 and 0.389 respectively. MVO size was found to be a significant factor affecting the patient’s outcome (p= 0.000) where MVO size of > 10% of the total LVM can be a predictor of a worse outcome and reduced EF% at follow-up.
Conclusion: The prognostic value of MVO could be statistically determined with a cut off value to predict a possible good outcome using cardiac MRI.