{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T10:54:51Z","timestamp":1791888891078,"version":"4.3.4"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Microvascular injury in the course of acute ST-segment\u2013elevation myocardial infarction (STEMI) has been identified as determinant of adverse outcomes and manifests as microvascular obstruction (MVO). MVO has long been regarded as a transient finding, vanishing within a few weeks after infarction. However, recent studies have shown that it may persist beyond the early phase, resulting in adverse remodeling. However, its clinical implications remain unclear. This study aims to evaluate the association of MVO persistence and major adverse cardiac events after STEMI.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>In total, 609 patients with revascularized first-time STEMI underwent cardiac magnetic resonance imaging (CMR) at 4 days, 4 months, and 12 months after STEMI to assess MVO, infarct size, and left ventricular function. Major adverse cardiac events were defined as composite of death, reinfarction, and new congestive heart failure within a median interval of 3.2 years.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              Baseline MVO was present in 365 (60%) patients and persisted in 35 (10%) patients at 4-month CMR and in 20 (5%) patients at 12-month CMR. Compared with transient MVO not present at follow-up, patients with MVO persistence \u22654 months were more likely to experience major adverse cardiac events during follow-up (29% versus 13%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.016). Within patients with MVO, those with MVO persistence had lower left ventricular ejection fraction (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.002), larger infarcts (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.00001), and more frequent intramyocardial hemorrhage (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.001) at baseline CMR.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Persistent MVO after STEMI occurs in up to 10% of patients with baseline MVO and is linked to major adverse cardiac events. Patients with MVO persistence had larger infarcts, lower left ventricular function, and more frequent intramyocardial hemorrhage at baseline CMR. All patients with MVO persisting \u226512 months initially showed intramyocardial hemorrhage.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.124.017645","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T09:00:19Z","timestamp":1747126819000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Clinical Impact of Persistent Microvascular Obstruction in CMR After Reperfused STEMI"],"prefix":"10.1161","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0401-5045","authenticated-orcid":true,"given":"Felix","family":"Troger","sequence":"first","affiliation":[{"name":"University Clinic of Radiology, Medical University of Innsbruck, Austria (F.T., M.P., P.P., M.S., B.H., A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9241-6334","authenticated-orcid":true,"given":"Mathias","family":"Pamminger","sequence":"additional","affiliation":[{"name":"University Clinic of Radiology, Medical University of Innsbruck, Austria (F.T., M.P., P.P., M.S., B.H., A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3388-7195","authenticated-orcid":true,"given":"Paulina","family":"Poskaite","sequence":"additional","affiliation":[{"name":"University Clinic of Radiology, Medical University of Innsbruck, Austria (F.T., M.P., P.P., M.S., B.H., A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8414-9552","authenticated-orcid":true,"given":"Martin","family":"Reindl","sequence":"additional","affiliation":[{"name":"University Clinic of Internal Medicine III, Medical University of Innsbruck, Austria (M.R., M.H., I.L., C.T., S.v.d.E., A.K., F.O., B.M., S.J.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2415-8622","authenticated-orcid":true,"given":"Magdalena","family":"Holzknecht","sequence":"additional","affiliation":[{"name":"University Clinic of Internal Medicine III, Medical University of Innsbruck, Austria (M.R., M.H., I.L., C.T., S.v.d.E., A.K., F.O., B.M., S.J.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1379-3233","authenticated-orcid":true,"given":"Ivan","family":"Lechner","sequence":"additional","affiliation":[{"name":"University Clinic of Internal Medicine III, Medical University of Innsbruck, Austria (M.R., M.H., I.L., C.T., S.v.d.E., A.K., F.O., B.M., S.J.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9181-1663","authenticated-orcid":true,"given":"Christina","family":"Tiller","sequence":"additional","affiliation":[{"name":"University Clinic of Internal Medicine III, Medical University of Innsbruck, Austria (M.R., M.H., I.L., C.T., S.v.d.E., A.K., F.O., B.M., S.J.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"von der Emde","sequence":"additional","affiliation":[{"name":"University Clinic of Internal Medicine III, Medical University of Innsbruck, Austria (M.R., M.H., I.L., C.T., S.v.d.E., A.K., F.O., B.M., S.J.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5393-5254","authenticated-orcid":true,"given":"Alex","family":"Kaser","sequence":"additional","affiliation":[{"name":"University Clinic of Internal Medicine III, Medical University of Innsbruck, Austria (M.R., M.H., I.L., C.T., 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