From the Cardiology Division, Department of Medicine (C.E.R., J.A.C.L.,
T.F., L.C.B.); Department of Radiology (J.A.C.L., D.A.B., E.R.M.); and
Department of Biomedical Engineering (E.R.M., S.B.R.), Johns Hopkins
University, Baltimore, Md, and the Division of Cardiology, Department of
Medicine, University of Louvain, Brussels, Belgium (J.A.M.).
Correspondence to João A.C. Lima, MD, Johns Hopkins Hospital, Cardiology Division, Blalock 569, 600 N Wolfe St, Baltimore, MD 21287-6568. E-mail jlima{at}welchlink.welch.jhu.edu
Background—Microvascular obstruction
within an area of myocardial infarction indicates worse functional
recovery and a higher risk of postinfarction complications. After
prolonged coronary occlusion, contrast-enhanced MRI identifies
myocardial infarction as a hyperenhanced region containing a
hypoenhanced core. Because the time course of microvascular obstruction
after infarction/reperfusion is unknown, we examined whether
microvascular obstruction reaches its full extent shortly after
reperfusion or shows significant progression over the following 2
days.
Methods and Results—Seven dogs underwent 90-minute balloon
occlusion of the left anterior descending coronary artery (LAD)
followed by reflow. Gadolinium-DTPA–enhanced MRI performed at 2, 6,
and 48 hours after reperfusion was compared with radioactive
microsphere blood flow (MBF) measurements and myocardial
staining to define microvascular obstruction (thioflavin S) and infarct
size (triphenyltetrazolium chloride, TTC).
The MRI hypoenhanced region increased 3-fold during 48 hours after
reperfusion (3.2±1.8%, 6.7±4.4%, and 9.9±3.2% of left
ventricular mass at 2, 6, and 48 hours, respectively,
P<0.03) and correlated well with microvascular
obstruction (MBF <50% of remote region, r=0.99 and
thioflavin S, r=0.93). MRI hyperenhancement also
increased (21.7±4.0%, 24.3±4.6%, and 28.8±5.1% at 2, 6, and 48
hours, P<0.006) and correlated well with infarct size
by TTC (r=0.92). The microvascular obstruction/infarct
size ratio increased from 13.0±4.8% to 22.6±8.9% and to 30.4±4.2%
over 48 hours (P=0.024).
Conclusions—The extent of microvascular obstruction and the
infarct size increase significantly over the first 48 hours after
myocardial infarction. These results are consistent with
progressive microvascular and myocardial injury well beyond
coronary occlusion and reflow.
© 1998 American Heart Association, Inc.
Basic Science Reports
Magnitude and Time Course of Microvascular Obstruction and Tissue Injury After Acute Myocardial Infarction
Key Words: magnetic resonance imaging • myocardial infarction • microcirculation • reperfusion • perfusion
This article has been cited by other articles:
 |
|
 |
|
  R. S. Schwartz, A. Burke, A. Farb, D. Kaye, J. R. Lesser, T. D. Henry, and R. Virmani Microemboli and Microvascular Obstruction in Acute Coronary Thrombosis and Sudden Coronary Death: Relation to Epicardial Plaque Histopathology J. Am. Coll. Cardiol., December 1, 2009; 54(23): 2167 - 2173. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Mikami, H. Sakuma, M. Nagata, M. Ishida, T. Kurita, I. Komuro, and M. Ito Relation Between Signal Intensity on T2-Weighted MR Images and Presence of Microvascular Obstruction in Patients With Acute Myocardial Infarction Am. J. Roentgenol., October 1, 2009; 193(4): W321 - W326. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. P. O'Regan, R. Ahmed, C. Neuwirth, Y. Tan, G. Durighel, J. V. Hajnal, I. Nadra, S. J. Corbett, and S. A. Cook Cardiac MRI of myocardial salvage at the peri-infarct border zones after primary coronary intervention Am J Physiol Heart Circ Physiol, July 1, 2009; 297(1): H340 - H346. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M Habis, A Capderou, A Sigal-Cinqualbre, S Ghostine, S Rahal, J Y Riou, P Brenot, C Y Angel, and J F Paul Comparison of delayed enhancement patterns on multislice computed tomography immediately after coronary angiography and cardiac magnetic resonance imaging in acute myocardial infarction Heart, April 1, 2009; 95(8): 624 - 629. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Lockie, E. Nagel, S. Redwood, and S. Plein Use of Cardiovascular Magnetic Resonance Imaging in Acute Coronary Syndromes Circulation, March 31, 2009; 119(12): 1671 - 1681. [Full Text] [PDF]
|
|
|
|
 |
|
 D. P. O'Regan, R. Ahmed, N. Karunanithy, C. Neuwirth, Y. Tan, G. Durighel, J. V. Hajnal, I. Nadra, S. J. Corbett, and S. A. Cook Reperfusion Hemorrhage Following Acute Myocardial Infarction: Assessment with T2* Mapping and Effect on Measuring the Area at Risk Radiology, March 1, 2009; 250(3): 916 - 922. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. C. Wu Fighting the "Fire" of Myocardial Reperfusion Injury: How to Define Success? J. Am. Coll. Cardiol., February 24, 2009; 53(8): 730 - 731. [Full Text] [PDF]
|
|
|
|
|
|
R. Nijveldt, M. B. M. Hofman, A. Hirsch, A. M. Beek, V. A. W. M. Umans, P. R. Algra, J. J. Piek, and A. C. van Rossum Assessment of Microvascular Obstruction and Prediction of Short-term Remodeling after Acute Myocardial Infarction: Cardiac MR Imaging Study Radiology, February 1, 2009; 250(2): 363 - 370. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. Yang, J. Linden, S. S. Berr, I. L. Kron, G. A. Beller, and B. A. French Timing of adenosine 2A receptor stimulation relative to reperfusion has differential effects on infarct size and cardiac function as assessed in mice by MRI Am J Physiol Heart Circ Physiol, December 1, 2008; 295(6): H2328 - H2335. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Boussel, M. Ribagnac, E. Bonnefoy, P. Staat, B. M. Elicker, D. Revel, and P. Douek Assessment of Acute Myocardial Infarction Using MDCT After Percutaneous Coronary Intervention: Comparison with MRI Am. J. Roentgenol., August 1, 2008; 191(2): 441 - 447. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Nijveldt, A. M. Beek, A. Hirsch, M. G. Stoel, M. B.M. Hofman, V. A.W.M. Umans, P. R. Algra, J. W.R. Twisk, and A. C. van Rossum Functional recovery after acute myocardial infarction comparison between angiography, electrocardiography, and cardiovascular magnetic resonance measures of microvascular injury. J. Am. Coll. Cardiol., July 15, 2008; 52(3): 181 - 189. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Saremi, J. D. Grizzard, and R. J. Kim Optimizing Cardiac MR Imaging: Practical Remedies for Artifacts1 RadioGraphics, July 1, 2008; 28(4): 1161 - 1187. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Hirsch, R. Nijveldt, J. D.E. Haeck, A. M. Beek, K. T. Koch, J. P.S. Henriques, R. J. van der Schaaf, M. M. Vis, J. Baan Jr, R. J. de Winter, et al. Relation between the assessment of microvascular injury by cardiovascular magnetic resonance and coronary Doppler flow velocity measurements in patients with acute anterior wall myocardial infarction. J. Am. Coll. Cardiol., June 10, 2008; 51(23): 2230 - 2238. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. E. Rochitte Microvascular obstruction the final frontier for a complete myocardial reperfusion. J. Am. Coll. Cardiol., June 10, 2008; 51(23): 2239 - 2240. [Full Text] [PDF]
|
|
|
|
|
|
N. Ojha, S. Roy, J. Radtke, O. Simonetti, S. Gnyawali, J. L. Zweier, P. Kuppusamy, and C. K. Sen Characterization of the structural and functional changes in the myocardium following focal ischemia-reperfusion injury Am J Physiol Heart Circ Physiol, June 1, 2008; 294(6): H2435 - H2443. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Nieman, M. D. Shapiro, M. Ferencik, C. H. Nomura, S. Abbara, U. Hoffmann, H. K. Gold, I.-K. Jang, T. J. Brady, and R. C. Cury Reperfused Myocardial Infarction: Contrast-enhanced 64-Section CT in Comparison to MR Imaging Radiology, April 1, 2008; 247(1): 49 - 56. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. R. S. Fernandes, K. C. Wu, B. D. Rosen, A. Schmidt, A. C. Lardo, N. Osman, H. R. Halperin, G. Tomaselli, R. Berger, D. A. Bluemke, et al. Enhanced Infarct Border Zone Function and Altered Mechanical Activation Predict Inducibility of Monomorphic Ventricular Tachycardia in Patients with Ischemic Cardiomyopathy Radiology, December 1, 2007; 245(3): 712 - 719. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Valina, K. Pinkernell, Y.-H. Song, X. Bai, S. Sadat, R. J. Campeau, T. H. Le Jemtel, and E. Alt Intracoronary administration of autologous adipose tissue-derived stem cells improves left ventricular function, perfusion, and remodelling after acute myocardial infarction Eur. Heart J., November 1, 2007; 28(21): 2667 - 2677. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Lessick, R. Dragu, D. Mutlak, S. Rispler, R. Beyar, D. Litmanovich, A. Engel, Y. Agmon, M. Kapeliovich, H. Hammerman, et al. Is Functional Improvement after Myocardial Infarction Predicted with Myocardial Enhancement Patterns at Multidetector CT? Radiology, September 1, 2007; 244(3): 736 - 744. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 X. Zhu, Z. Li, and M. Zhao Imaging Acute Cardiac Cell Death: Temporal and Spatial Distribution of 99mTc-Labeled C2A in the Area at Risk After Myocardial Ischemia and Reperfusion J. Nucl. Med., June 1, 2007; 48(6): 1031 - 1036. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Schmidt, C. F. Azevedo, A. Cheng, S. N. Gupta, D. A. Bluemke, T. K. Foo, G. Gerstenblith, R. G. Weiss, E. Marban, G. F. Tomaselli, et al. Infarct Tissue Heterogeneity by Magnetic Resonance Imaging Identifies Enhanced Cardiac Arrhythmia Susceptibility in Patients With Left Ventricular Dysfunction Circulation, April 17, 2007; 115(15): 2006 - 2014. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Habis, A. Capderou, S. Ghostine, B. Daoud, C. Caussin, J.-Y. Riou, P. Brenot, C. Y. Angel, B. Lancelin, and J.-F. Paul Acute Myocardial Infarction Early Viability Assessment by 64-Slice Computed Tomography Immediately After Coronary Angiography: Comparison With Low-Dose Dobutamine Echocardiography J. Am. Coll. Cardiol., March 20, 2007; 49(11): 1178 - 1185. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R Montisci, L Chen, M Ruscazio, P Colonna, C Cadeddu, C Caiati, M Montisci, L Meloni, and S Iliceto Non-invasive coronary flow reserve is correlated with microvascular integrity and myocardial viability after primary angioplasty in acute myocardial infarction Heart, August 1, 2006; 92(8): 1113 - 1118. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. J. van den Bos, T. Baks, A. D. Moelker, W. Kerver, R.-J. van Geuns, W. J. van der Giessen, D. J. Duncker, and P. A. Wielopolski Magnetic resonance imaging of haemorrhage within reperfused myocardial infarcts: possible interference with iron oxide-labelled cell tracking? Eur. Heart J., July 1, 2006; 27(13): 1620 - 1626. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. C. Cury, C. A. M. Cattani, L. A. G. Gabure, D. J. Racy, J. M. de Gois, U. Siebert, S. S. Lima, and T. J. Brady Diagnostic Performance of Stress Perfusion and Delayed-Enhancement MR Imaging in Patients with Coronary Artery Disease. Radiology, July 1, 2006; 240(1): 39 - 45. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Prech, S. Grajek, A. Marszalek, M. Lesiak, M. Jemielity, A. Araszkiewicz, T. Mularek-Kubzdela, and A. Cieslinski Chronic infarct-related artery occlusion is associated with a reduction in capillary density. Effects on infarct healing Eur J Heart Fail, June 1, 2006; 8(4): 373 - 380. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Thiele, M. J.E. Kappl, S. Conradi, J. Niebauer, R. Hambrecht, and G. Schuler Reproducibility of Chronic and Acute Infarct Size Measurement by Delayed Enhancement-Magnetic Resonance Imaging J. Am. Coll. Cardiol., April 18, 2006; 47(8): 1641 - 1645. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Dickfeld, R. Kato, M. Zviman, S. Lai, G. Meininger, A. C. Lardo, A. Roguin, D. Blumke, R. Berger, H. Calkins, et al. Characterization of Radiofrequency Ablation Lesions With Gadolinium-Enhanced Cardiovascular Magnetic Resonance Imaging J. Am. Coll. Cardiol., January 17, 2006; 47(2): 370 - 378. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Bodi, J. Sanchis, M. P. Lopez-Lereu, A. Losada, J. Nunez, M. Pellicer, V. Bertomeu, F. J. Chorro, and A. Llacer Usefulness of a Comprehensive Cardiovascular Magnetic Resonance Imaging Assessment for Predicting Recovery of Left Ventricular Wall Motion in the Setting of Myocardial Stunning J. Am. Coll. Cardiol., November 1, 2005; 46(9): 1747 - 1752. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. E. Rochitte, P. F. Oliveira, J. M. Andrade, B. M. Ianni, J. R. Parga, L. F. Avila, R. Kalil-Filho, C. Mady, J. C. Meneghetti, J. A.C. Lima, et al. Myocardial Delayed Enhancement by Magnetic Resonance Imaging in Patients With Chagas' Disease: A Marker of Disease Severity J. Am. Coll. Cardiol., October 18, 2005; 46(8): 1553 - 1558. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Staat, G. Rioufol, C. Piot, Y. Cottin, T. T. Cung, I. L'Huillier, J.-F. Aupetit, E. Bonnefoy, G. Finet, X. Andre-Fouet, et al. Postconditioning the Human Heart Circulation, October 4, 2005; 112(14): 2143 - 2148. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. A. Krombach, C. B. Higgins, M. Chujo, and M. Saeed Gadomer-enhanced MR Imaging in the Detection of Microvascular Obstruction: Alleviation with Nicorandil Therapy Radiology, August 1, 2005; 236(2): 510 - 518. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Budoff, M. C. Cohen, M. J. Garcia, J. McB. Hodgson, W. G. Hundley, J. A.C. Lima, W. J. Manning, G. M. Pohost, P. M. Raggi, G. P. Rodgers, et al. ACCF/AHA Clinical Competence Statement on Cardiac Imaging With Computed Tomography and Magnetic Resonance: A Report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training J. Am. Coll. Cardiol., July 19, 2005; 46(2): 383 - 402. [Full Text] [PDF]
|
|
|
|
|
|
Y. Koyama, H. Matsuoka, T. Mochizuki, H. Higashino, H. Kawakami, S. Nakata, J. Aono, T. Ito, M. Naka, Y. Ohashi, et al. Assessment of Reperfused Acute Myocardial Infarction with Two-Phase Contrast-enhanced Helical CT: Prediction of Left Ventricular Function and Wall Thickness Radiology, June 1, 2005; 235(3): 804 - 811. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. C. Amado, B. L. Gerber, S. N. Gupta, D. W. Rettmann, G. Szarf, R. Schock, K. Nasir, D. L. Kraitchman, and J. A.C. Lima Accurate and objective infarct sizing by contrast-enhanced magnetic resonance imaging in a canine myocardial infarction model J. Am. Coll. Cardiol., December 21, 2004; 44(12): 2383 - 2389. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. J. Pennell, U. P. Sechtem, C. B. Higgins, W. J. Manning, G. M. Pohost, F. E. Rademakers, A. C. van Rossum, L. J. Shaw, and E. K. Yucel Clinical indications for cardiovascular magnetic resonance (CMR): Consensus Panel report Eur. Heart J., November 1, 2004; 25(21): 1940 - 1965. [Full Text] [PDF]
|
|
|
|
|
|
L. L. Johnson, L. Schofield, M. Bouchard, L. Chaves, A. Poppas, S. Reinert, P. Zalesky, J. Creech, and D. O. Williams Hyperbaric oxygen solution infused into the anterior interventricular vein at reperfusion reduces infarct size in swine Am J Physiol Heart Circ Physiol, November 1, 2004; 287(5): H2234 - H2240. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A.C. Lima and M. Y. Desai Cardiovascular magnetic resonance imaging: Current and emerging applications J. Am. Coll. Cardiol., September 15, 2004; 44(6): 1164 - 1171. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Reffemann and R. A. Kloner Microvascular Alterations After Temporary Coronary Artery Occlusion: The No-Reflow Phenomenon Journal of Cardiovascular Pharmacology and Therapeutics, July 1, 2004; 9(3): 163 - 172. [Abstract] [PDF]
|
|
|
|
|
|
G. K. Lund, A. Stork, M. Saeed, M. P. Bansmann, J. H. Gerken, V. Muller, J. Mester, C. B. Higgins, G. Adam, and T. Meinertz Acute Myocardial Infarction: Evaluation with First-Pass Enhancement and Delayed Enhancement MR Imaging Compared with 201Tl SPECT Imaging Radiology, July 1, 2004; 232(1): 49 - 57. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. S. Fieno, H. B. Hillenbrand, W. G. Rehwald, K. R. Harris, R. S. Decker, M. A. Parker, F. J. Klocke, R. J. Kim, and R. M. Judd Infarct resorption, compensatory hypertrophy, and differing patterns of ventricular remodeling following myocardial infarctions of varying size J. Am. Coll. Cardiol., June 2, 2004; 43(11): 2124 - 2131. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. C. Amado, D. L. Kraitchman, B. L. Gerber, E. Castillo, R. C. Boston, J. Grayzel, and J. A. C. Lima Reduction of "no-reflow" phenomenon by intra-aortic balloon counterpulsation in a randomized magnetic resonance imaging experimental study J. Am. Coll. Cardiol., April 7, 2004; 43(7): 1291 - 1298. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. Yang, S. S. Berr, W. D. Gilson, M.-C. Toufektsian, and B. A. French Simultaneous Evaluation of Infarct Size and Cardiac Function in Intact Mice by Contrast-Enhanced Cardiac Magnetic Resonance Imaging Reveals Contractile Dysfunction in Noninfarcted Regions Early After Myocardial Infarction Circulation, March 9, 2004; 109(9): 1161 - 1167. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. K. F. Foo, D. W. Stanley, E. Castillo, C. E. Rochitte, Y. Wang, J. A. C. Lima, D. A. Bluemke, and K. C. Wu Myocardial Viability: Breath-hold 3D MR Imaging of Delayed Hyperenhancement with Variable Sampling in Time Radiology, March 1, 2004; 230(3): 845 - 851. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. C. Wu and J. A.C. Lima Noninvasive Imaging of Myocardial Viability: Current Techniques and Future Developments Circ. Res., December 12, 2003; 93(12): 1146 - 1158. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Reffelmann, S. L. Hale, J. S. Dow, and R. A. Kloner No-Reflow Phenomenon Persists Long-Term After Ischemia/Reperfusion in the Rat and Predicts Infarct Expansion Circulation, December 9, 2003; 108(23): 2911 - 2917. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T Hozumi, Y Kanzaki, Y Ueda, A Yamamuro, T Takagi, T Akasaka, S Homma, K Yoshida, and J Yoshikawa Coronary flow velocity analysis during short term follow up after coronary reperfusion: use of transthoracic Doppler echocardiography to predict regional wall motion recovery in patients with acute myocardial infarction Heart, October 1, 2003; 89(10): 1163 - 1168. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. C. Lima Myocardial viability assessment by contrast-enhanced magnetic resonance imaging J. Am. Coll. Cardiol., September 3, 2003; 42(5): 902 - 904. [Full Text] [PDF]
|
|
|
|
|
|
J. Schulz-Menger, M. Gross, D. Messroghli, F. Uhlich, R. Dietz, and M. G. Friedrich Cardiovascular magnetic resonance ofacute myocardial infarction at a very early stage J. Am. Coll. Cardiol., August 6, 2003; 42(3): 513 - 518. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z.-Q. Z.-Q. Zhao, C. D. Morris, J. M. Budde, N.-P. N.-P. Wang, S. Muraki, H.-Y. H.-Y. Sun, and R. A. Guyton Inhibition of myocardial apoptosis reduces infarct size and improves regional contractile dysfunction during reperfusion Cardiovasc Res, July 1, 2003; 59(1): 132 - 142. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y Nohtomi, M Takeuchi, K Nagasawa, K Arimura, K Miyata, K Kuwata, T Yamawaki, S Kondo, A Yamada, and S Okamatsu Persistence of systolic coronary flow reversal predicts irreversible dysfunction after reperfused anterior myocardial infarction Heart, April 1, 2003; 89(4): 382 - 388. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F Beygui, C Le Feuvre, G Helft, C Maunoury, and J P Metzger Myocardial viability, coronary flow reserve, and in-hospital predictors of late recovery of contractility following successful primary stenting for acute myocardial infarction Heart, February 1, 2003; 89(2): 179 - 183. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. M. Petre, F. A. Baciewicz Jr, S. Tigan, and J. R. Spears Hyperbaric oxygen as a chemotherapy adjuvant in the treatment of metastatic lung tumors in a rat model J. Thorac. Cardiovasc. Surg., January 1, 2003; 125(1): 85 - 95. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. A. Krombach, M. F. Wendland, C. B. Higgins, and M. Saeed MR Imaging of Spatial Extent of Microvascular Injury in Reperfused Ischemically Injured Rat Myocardium: Value of Blood Pool Ultrasmall Superparamagnetic Particles of Iron Oxide Radiology, November 1, 2002; 225(2): 479 - 486. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Reffelmann and R. A. Kloner Microvascular reperfusion injury: rapid expansion of anatomic no reflow during reperfusion in the rabbit Am J Physiol Heart Circ Physiol, September 1, 2002; 283(3): H1099 - H1107. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. L. Gerber, J. Garot, D. A. Bluemke, K. C. Wu, and J. A.C. Lima Accuracy of Contrast-Enhanced Magnetic Resonance Imaging in Predicting Improvement of Regional Myocardial Function in Patients After Acute Myocardial Infarction Circulation, August 27, 2002; 106(9): 1083 - 1089. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z.-Q. Zhao and J. Vinten-Johansen Myocardial apoptosis and ischemic preconditioning Cardiovasc Res, August 15, 2002; 55(3): 438 - 455. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Lepper, G. T. j Sieswerda, A. Franke, N. Heussen, O. Kamp, C. C. de Cock, E. R. Schwarz, P. Voci, C. A. Visser, P. Hanrath, et al. Repeated assessment of coronary flow velocity pattern in patients with first acute myocardial infarction J. Am. Coll. Cardiol., April 17, 2002; 39(8): 1283 - 1289. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Agati, S. Funaro, M. Madonna, C. Volponi, G. Veneroso, and G. Tonti Clinical utility of contrast echocardiography in the management of patients with acute myocardial infarction Eur. Heart J. Suppl., March 1, 2002; 4(suppl_C): C27 - C34. [Abstract] [PDF]
|
|
|
|
|
|
S. H. Rezkalla and R. A. Kloner No-Reflow Phenomenon Circulation, February 5, 2002; 105(5): 656 - 662. [Full Text] [PDF]
|
|
|
|
|
|
T. Reffelmann and R. A Kloner The "no-reflow" phenomenon: basic science and clinical correlates Heart, February 1, 2002; 87(2): 162 - 168. [Full Text] [PDF]
|
|
|
|
|
|
G. Horstick, O. Berg, A. Heimann, O. Gotze, M. Loos, G. Hafner, B. Bierbach, S. Petersen, S. Bhakdi, H. Darius, et al. Application of C1-Esterase Inhibitor During Reperfusion of Ischemic Myocardium: Dose-Related Beneficial Versus Detrimental Effects Circulation, December 18, 2001; 104(25): 3125 - 3131. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. N. Oshinski, Z. Yang, J. R. Jones, J. F. Mata, and B. A. French Imaging Time After Gd-DTPA Injection Is Critical in Using Delayed Enhancement to Determine Infarct Size Accurately With Magnetic Resonance Imaging Circulation, December 4, 2001; 104(23): 2838 - 2842. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. J. W. Sandstede, T. Pabst, M. Beer, C. Lipke, K. Baurle, F. Butter, K. Harre, W. Kenn, W. Voelker, S. Neubauer, et al. Assessment of Myocardial Infarction in Humans with 23Na MR Imaging: Comparison with Cine MR Imaging and Delayed Contrast Enhancement Radiology, October 1, 2001; 221(1): 222 - 228. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. L. Gerber, C. E. Rochitte, D. A. Bluemke, J. A. Melin, P. Crosille, L. C. Becker, and J. A.C. Lima Relation Between Gd-DTPA Contrast Enhancement and Regional Inotropic Response in the Periphery and Center of Myocardial Infarction Circulation, August 28, 2001; 104(9): 998 - 1004. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. B. Reeder, Y. P. Du, J. A. C. Lima, and D. A. Bluemke Advanced Cardiac MR Imaging of Ischemic Heart Disease RadioGraphics, July 1, 2001; 21(4): 1047 - 1074. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Hattori, H. Otani, Y. Moriguchi, H. Matsubara, T. Yamamura, Y. Nakao, H. Omiya, M. Osako, and H. Imamura NHE and ICAM-1 expression in hypoxic/reoxygenated coronary microvascular endothelial cells Am J Physiol Heart Circ Physiol, June 1, 2001; 280(6): H2796 - H2803. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U. Sechtem Imaging myocardial area at risk and final infarct size Eur. Heart J. Suppl., June 1, 2001; 3(suppl_C): C36 - C46. [PDF]
|
|
|
|
|
|
E Eeckhout and M.J Kern The coronary no-reflow phenomenon: a review of mechanisms and therapies Eur. Heart J., May 1, 2001; 22(9): 729 - 739. [PDF]
|
|
|
|
 |
|
 M. Saeed New Concepts in Characterization of Ischemically Injured Myocardium by MRI Experimental Biology and Medicine, May 1, 2001; 226(5): 367 - 376. [Abstract] [Full Text]
|
|
|
|
|
|
O. P. Simonetti, R. J. Kim, D. S. Fieno, H. B. Hillenbrand, E. Wu, J. M. Bundy, J. P. Finn, and R. M. Judd An Improved MR Imaging Technique for the Visualization of Myocardial Infarction Radiology, January 1, 2001; 218(1): 215 - 223. [Abstract] [Full Text]
|
|
|
|
|
|
D. S. Fieno, R. J. Kim, E.-L. Chen, J. W. Lomasney, F. J. Klocke, and R. M. Judd Contrast-enhanced magnetic resonance imaging of myocardium at risk: Distinction between reversible and irreversible injury throughout infarct healing J. Am. Coll. Cardiol., November 15, 2000; 36(6): 1985 - 1991. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. E. Rochitte, R. J. Kim, H. B. Hillenbrand, E.-l. Chen, and J. A. C. Lima Microvascular Integrity and the Time Course of Myocardial Sodium Accumulation After Acute Infarction Circ. Res., October 13, 2000; 87(8): 648 - 655. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M Budde, D. A Velez, Z.-Q. Zhao, K. L Clark, C. D Morris, S. Muraki, R. A Guyton, and J. Vinten-Johansen Comparative study of AMP579 and adenosine in inhibition of neutrophil-mediated vascular and myocardial injury during 24 h of reperfusion Cardiovasc Res, August 1, 2000; 47(2): 294 - 305. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. L. Gerber, C. E. Rochitte, J. A. Melin, E. R. McVeigh, D. A. Bluemke, K. C. Wu, L. C. Becker, and J. A. C. Lima Microvascular Obstruction and Left Ventricular Remodeling Early After Acute Myocardial Infarction Circulation, June 13, 2000; 101(23): 2734 - 2741. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. E. Jordan, Z.-Q. Zhao, and J. Vinten-Johansen The role of neutrophils in myocardial ischemia-reperfusion injury Cardiovasc Res, September 1, 1999; 43(4): 860 - 878. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. C. Wu, R. J. Kim, D. A. Bluemke, C. E. Rochitte, E. A. Zerhouni, L. C. Becker, and J. A. C. Lima Quantification and time course of microvascular obstruction by contrast-enhanced echocardiography and magnetic resonance imaging following acute myocardial infarction and reperfusion J. Am. Coll. Cardiol., November 15, 1998; 32(6): 1756 - 1764. [Abstract] [Full Text] [PDF]
|
|