P5254Prognostic value and clinical predictors of Intramyocardial Hemorrhage measured by CMR T2 weighted sequences

Abstract In the setting of STEMI, microvascular injury consists of microvascular obstruction (MVO) and intramyocardial hemorrhage (IMH). We aimed to investigate prognostic value and clinical predictors of MR T2* w analysis of IMH in this setting. Methods A single center observational cohort study was performed in patients with reperfused STEMI with CMR examination after percutaneous revascularization. Infarct related CMR characteristics were analyzed in whole LV short-axis late gadolinium enhancement sequences (LGE) for infarct size and MVO and whole volume T2*w sequences for IMH. Extent of MVO and IMH were derived as percentage of LV mass. Kaplan-Meier was used to analyze the incidence of major adverse cardiovascular events, defined as a composite of cardiac death, myocardial re-infarction, and new congestive heart failure. Results 94 reperfused STEMI patients were included in the study. T2*w IMH was present in 26 (28%) patients and the median size of IMH was 1.1% (IQR: 0.5 to 2.9%). MVO was identified in 49 (52%) patients and the median size of MVO was 3% mass (IQR: 1.5 to 5.4%). T2*w IMH extension was independently associated with anterior myocardial infarction (p=0.022) and thrombectomy (p=0.049). IMH was correlated with MVO (R=0.62, p