Comparison of two visual angiographic perfusion grades in acute myocardial infarction.
BACKGROUND
Prognosis after opening the obstructed coronary artery in acute myocardial infarction (AMI) is influenced by several factors. In routine clinical practice, revascularization is considered to be successful when the restoration of epicardial blood-flow is complete. However, the patent epicardial artery does not always provide functional recovery in the myocardium. There are two visual angiographic grades to assess myocardial perfusion: myocardial blush grade (MBG) and TIMI myocardial perfusion grade (TMP). The aim of our study was to compare these two parameters, how they correlate with short-term indicators of myocardial damage.


METHODS
The two visual grades were assessed along with enzymatic infarct size as creatine kinase release (CK), echocardiographic left ventricular ejection fraction (LVEF), and ST-segment resolution (STR) in 62 patients with acute myocardial infarction and successful revascularization.


RESULTS
Better correlation was found with TMP in case of all clinical parameters (CK: R= - 0.687, P<0.001; LVEF: R=0.586, P<0.001; STR: R=0.574, P<0.001). MBG also showed significant correlations with clinical measurements, except for enzymatic infarct size (CK: R=- 0.062, P=0.626; LVEF: R=0.389, P=0.002; STR: R=0.348, P=0.006).


CONCLUSIONS
Our findings suggest that the clearance of the dye (described by TMP) is more characteristic to myocardial recovery after AMI, than maximal contrast density (described by MBG) in the clinical practice.
Ungi
Tamás
T
Department of Radiology, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.
Sasi
Viktor
V
Ungi
Imre
I
Forster
Tamás
T
Palkó
András
A
Nemes
Attila
A
D000368:Aged; D000792:Angiography; D003402:Creatine Kinase / Q000378:metabolism; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D010477:Perfusion; D013318:Stroke Volume
D003402:Creatine Kinase