O11-3 - Intramyocardial Hemorrhage Assessed by T2* Imaging is Associated with Myocardial Damage and May Predicts Long-Term Outcome in Patients with Acs

Abstract

Microvascular obstruction (MVO) is recognized as one of complications of acute reperfused myocardial infarction (AMI). Recently it has been reported that intramyocardial hemorrhage (IMH) has the part of what had been recognized as MVO by T2* cardiovascular magnetic resonance imaging (CMR). We aimed to distinguish IMH within MVO and evaluate relationships between presence of IMH and disease severity in patients with AMI.Forty-five consecutive AMI patients that had undergone primary PCI were categorized into three groups whether the presence or absence of MVO and IMH. We assessed the values of MAX-CK, MAX-CKMB, LGE-volume, MVO-volume, TIMI-grade score and Blush-grade score in the acute phase, and LVEF, LVEDV, ESV, CI, and LV-mass in the chronic phase.There was statistically significant difference between the three groups regarding MAX-CK (6295.8 ± 3472.4, 2082.6 ± 854.4, 612.7 ± 337.9, P = .01), MAX-CKMB (365.8 ± 254.1, 200.2 ± 152.1, 55.1 ± 44.7, P = .01), LGE-volume (39.5 ± 20.0,17.2 ± 6.7, 5.2 ± 4.2, P = .01), and Blush-grade score (P = .015). In chronic phase, LVEF tended to be deteriorated in IMH(+) group, while IMH(-) group showed LVEF improvement. Furthermore, both LVEDV and ESV were increased in IMH(+) group, whereas both parameters were decreased in IMH(-) group.In conclusion, presence of intramyocardial hemorrhage revealed by T2* CMR indicates severe myocardial damage and may predicts worse outcome in patients with AMI.