MRI of Myocardial Infarction

Heart failure (HF) is an enormous health burden affecting approximately 5.1 million people in
the US and is the cause of 250,000 deaths each year. Approximately 50% of HF is caused by
myocardial ischemia and requires immediate restoration of coronary blood flow to the affected
myocardium. However, the success of reperfusion is partly limited by intramyocardial
hemorrhage, which is the deposition of intravascular material into the myocardium.
Hemorrhagic reperfusion injury has high prevalence and patients have a much greater risk of
adverse left ventricular remodeling, risk of fatal arrhythmia, impaired systolic function and
are hospitalized at a greater rate. Recent magnetic resonance imaging techniques have
improved assessment of reperfusion injury, however, the association between MRI contrasts and
reperfusion injury is highly unclear, and lacks specificity to IMH. Improved imaging of IMH
and accurate knowledge about its spatial and temporal evolution may be essential for delivery
of optimal medical therapy in patients and critical to identify patients most at risk for
adverse ventricular remodeling. The overall goal is to investigate the magnetic properties of
hemorrhage and develop MRI techniques with improved specificity to hemorrhage. New MRI
techniques permit noninvasive assessment of the magnetic susceptibility of tissues and can
target tissue iron. Therefore, the investigators hypothesize that MRI imaging of myocardial
magnetic susceptibility can map hemorrhagic myocardium. The investigators will perform a
longitudinal observational study in patients after reperfusion injury to validate these
methods, compare the methods with conventional MR contrasts and develop MR methods for
imaging humans.