Protti A, Dong X, Sirker A, Botnar R, Shah AM. MRI-based prediction of adverse cardiac remodeling after murine myocardial infarction. Am J Physiol Heart Circ Physiol 303: H309 -H314, 2012. First published May 25, 2012; doi:10.1152/ajpheart.00208.2012 results in adverse cardiac remodeling leading to heart failure and increased mortality. Experimental mouse models of MI are extensively used to identify mechanisms underlying adverse remodeling, but the extent of remodeling that occurs may be highly variable and can limit the utility to discover new disease pathways. The ability to predict the development of significant late post-MI remodeling would be invaluable in conducting such studies by increasing throughput and efficiency. This study aimed to identify potential thresholds of cardiac magnetic resonance imaging (MRI) parameters measured early after murine MI that would predict the development of significant adverse remodeling at 4 wk. MI was achieved by permanent coronary ligation and animals (n ϭ 84) were followed up for 4 wk subsequently. MRI was used to assess left ventricular (LV) volumes, mass and ejection fraction, as well as infarct size (IS). Late gadolinium enhancement cine-MRI was performed at 2 days with standard cine-MRI at 30 days post-MI. Utilizing multiple logistic regression, we found that IS Ͼ36%, at 2 days post-MI, was the overall best single predictor of adverse remodeling at 30 days (sensitivity 80.7%, specificity 88.9%; C-statistic of 0.939 from receiver-operating curve analysis). LV end-systolic volume (LVESV) Ͼ32 l was also an excellent predictor comparable to IS. The combination of IS Ͼ36% and/or LVESV Ͼ32 l provided the highest predictive values for late adverse remodeling among multiple predictors. This study demonstrates that MRIbased estimation of IS and ESV during the acute phase of murine MI are good predictors of subsequent adverse remodeling that may aid experimental design. remodeling prediction; magnetic resonance imaging; infarct size; ejection fraction MYOCARDIAL INFARCTION (MI) is commonly followed by adverse left ventricular (LV) remodeling involving significant changes in LV geometry and function (4). Such adverse remodeling contributes to impaired cardiac function and is a major cause of heart failure and increased mortality (25). Experimental models of MI, for example, as induced by permanent coronary ligation in gene-modified mice, are extensively utilized to elucidate pathophysiological and molecular mechanisms underlying cardiac remodeling that could be therapeutically targeted (5,17,18,22,23,27). The extent of adverse remodeling that occurs after experimental MI in murine models, as manifest by an increase in LV end-diastolic and end-systolic volumes (LVEDV and LVESV, respectively) and a reduction in ejection fraction (EF), can be highly variable and can limit their utility to discover new disease pathways (23,29). This is most likely related to variations in the severity and extent of myocardial injury that is induced by coronary ligation in mouse models (15,23,28,2...