PURPOSE: To prospectively evaluate the accuracy of clinical and cardiac magnetic resonance (MR) imaging parameters for predicting left ventricular (LV) remodeling by using follow-up imaging as reference standard, and to prospectively evaluate infarct resorption in patients with reperfused first myocardial infarcts. MATERIALS AND METHODS: The study was approved by the institutional ethics committee and all patients gave written informed consent. In 55 patients (48 men, seven women; mean age+/-standard deviation, 56 years+/-13), contrast material-enhanced and cine MR imaging were performed 5 days+/-3 and 8 months+/-3 after myocardial infarction (MI). Microvascular obstruction (MO) and infarct size were estimated at first-pass enhancement (FPE) and delayed enhancement (DE) MR, respectively. Remodeling was defined as an increase in LV end-diastolic volume index of 20% or higher at follow-up. Differences in continuous and categorical data were analyzed by using Student t test and Fischer exact test as appropriate. RESULTS: Patients with remodeling (n=13, 24%) had higher creatine kinase MB (P