Microvascular obstruction (MVO) is a frequent complication in acute myocardial infarction (AMI). A comprehensive regional and serial characterization of tissue response in the presence and absence of MVO will help assess the high-risk patients. In this study, we utilized T1 and T2 relaxation as well as tissue strain properties to evaluate tissue response in STEMI patient’s post-AMI. We observed that measures of infarct edema, hemorrhage and strain in patients with MVO fail to recover to remote levels and have significantly lower recovery rates compared to patients without MVO. Remote T2 alterations may further be an early indicator of adverse remodeling. Our study shows that MVO impacts disease progression by hindering the regional myocardial systolic function and edema recovery post-AMI.
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