CMR of microvascular obstruction and hemorrhage in myocardial infarctionReport as inadecuate

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Journal of Cardiovascular Magnetic Resonance

, 14:68

First Online: 29 September 2012Received: 30 March 2012Accepted: 03 September 2012


Microvascular obstruction MO or no-reflow phenomenon is an established complication of coronary reperfusion therapy for acute myocardial infarction. It is increasingly recognized as a poor prognostic indicator and marker of subsequent adverse LV remodeling. Although MO can be assessed using various imaging modalities including electrocardiography, myocardial contrast echocardiography, nuclear scintigraphy, and coronary angiography, evaluation by cardiovascular magnetic resonance CMR is particularly useful in enhancing its detection, diagnosis, and quantification, as well as following its subsequent effects on infarct evolution and healing. MO assessment has become a routine component of the CMR evaluation of acute myocardial infarction and will increasingly play a role in clinical trials of adjunctive reperfusion agents and strategies. This review will summarize the pathophysiology of MO, current CMR approaches to diagnosis, clinical implications, and future directions needed for improving our understanding of this common clinical problem.

KeywordsMicrovascular obstruction Myocardial infarction Cardiac magnetic resonance Myocardial hemorrhage Electronic supplementary materialThe online version of this article doi:10.1186-1532-429X-14-68 contains supplementary material, which is available to authorized users.

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Author: Katherine C Wu


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