Epicardial Surface Area of Infarction

Background: Microvascular obstruction (MO) is a pathophysiologic complication of acute myocardial infarction that portends poor prognosis; however, it transient and disappears with infarct healing. Much remains unknown regarding its pathophysiology whether there are predictors MO could function as stable surrogates. We tested for clinical cardiovascular magnetic resonance to gain insight into find surrogate. Methods: Three hundred two consecutive patients from 2 centers underwent within weeks first infarction. measures morphology: size, transmurality, new index—the epicardial surface area (EpiSA) full-thickness infarction—were quantified on delayed-enhancement resonance. Results: Considering all characteristics, only morphology were independent MO. EpiSA was the strongest predictor provided incremental predictive value beyond size transmurality ( P <0.0001). In 3-month follow-up (n=81), extent remained while disappeared, adverse ventricular remodeling. After 20 months follow-up, 11 died 1 had heart transplantation. Patients an larger than median (≥6%) worse outcome those less (adverse events: 6.4% versus 1.9%, =0.045). Conclusions: The novel index which accurately predicts during MI, but unlike MO, does not disappear This has potential surrogate presence may be useful remodeling dependent time window patient assessment.