MRI quantification of left ventricular function in microinfarct versus large infarct in swine model.

To quantify, using MRI, the acute impacts of defined volume and sizes of coronary microemboli on myocardial viability and left ventricular (LV) function and to use LAD occlusion/reperfusion, as a reference. A total of 28 farm pigs were used in this study. Eight animals were used as controls. Successful coronary interventions were performed under X-ray fluoroscopy in 16 pigs to induce microinfarct (delivery of 16 mm(3) of 40-120 μm) and large infarct (90 min LAD occlusion/reperfusion). On day 3, animals were imaged using contrast enhanced (in beating and non-beating hearts) and cine MRI for evaluating LV viability and function, respectively. Microscopy and cardiac injury enzymes were used to confirm the presence of necrosis. Myocardial damage was smaller after microembolization than occlusion/reperfusion (6.5 ± 0.6%LV mass vs. 12.6 ± 1.2%, P < 0.001). The increase in LV end-systolic volume and decreases in ejection fraction, cardiac output and regional systolic wall thickening, however, were comparable between groups, but significantly differed from controls. MRI also demonstrated microvascular obstruction after microembolization and occlusion/reperfusion as hyperenhanced and hypoenhanced regions, respectively. Microscopic examination revealed patchy necrosis, inflammatory cell infiltration, but no intramyocardial hemorrhage after microembolization and extensive intramyocardial hemorrhage and transmural damage in the occlusion/reperfusion group. Cardiac injury enzymes confirmed presence of myocardial damage in animals with interventions. Coronary microemboli have acute impact on LV function compared to control animals. Despite the difference in myocardial damage, global and regional LV dysfunction after microembolization was comparable to occlusion/reperfusion. This MR study suggests that the pattern of myocardial damage plays a role in LV dysfunction.