Myocardial reperfusion: its assessment and its relation to clinical outcomes.
It has become increasingly apparent that epicardial blood flow restoration is necessary, but not sufficient, to achieve optimal clinical outcomes in the setting of acute coronary syndromes. Indeed, clinical outcomes are strongly associated with myocardial perfusion. The diagnostic tools available to assess myocardial perfusion following acute myocardial infarction and their association with clinical outcomes are reviewed here. Many simple angiographic markers--the Thrombolysis in Myocardial Infarction (TIMI) count frame, TIMI myocardial perfusion grade, pulsatile flow--are all readily available measures and are strongly related to clinical outcomes. Other tools, while accurate, remain limited by their high cost, low availability, and complexity for routine use.
Dumaine
Raphaëlle
R
TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham & Women's Hospital, Boston MA 02115, USA.
Bigelow
Brian
B
Aroesty
Julian
J
Gibson
C Michael
CM
D015901:Angiography, Digital Subtraction; D015906:Angioplasty, Balloon, Coronary; D003287:Contrast Media; D003326:Coronary Circulation; D015150:Echocardiography, Doppler; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D015425:Myocardial Reperfusion; D018570:Risk Assessment; D015912:Thrombolytic Therapy; D016896:Treatment Outcome
D003287:Contrast Media