title: TIMI myocardial perfusion frame count: a new method to assess myocardial perfusion and its predictive value for short-term prognosis.
abstract: OBJECTIVE
  We sought to develop a new quantitative method to evaluate the degree of myocardial perfusion.
  
  
  BACKGROUND
  Currently available methods for assessing myocardial perfusion, both TIMI myocardial perfusion grading (TMPG) and myocardial blush grading (MBG), are subjective.
  
  
  METHODS
  TIMI Myocardial Perfusion Frame Count (TMPFC), an objective method that measures the filling and clearance of contrast in the myocardium using cine-angiographic frame-counting, was developed to quantify myocardial perfusion. Myocardial perfusion of 45 normal coronary arteries in 15 patients, and 137 culprit arteries in 137 patients immediately after primary angioplasty, was successfully assessed with TMPFC.
  
  
  RESULTS
  The mean TMPFC in the normal arteries was 83.47 +/- 17.96 frames (95% CI: 78.07 frames <or= TMPFC <or= 88.86 frames). Therefore, TMPFC < 90 frames, a value representing the upper bound of the 95% CI for the TMPFC observed in normal arteries, was defined as normal myocardial perfusion. In 137 culprit arteries, the mean TMPFC values after primary angioplasty for the right coronary artery (RCA), left anterior descending artery (LAD), and left circumflex artery (LCX) were 141 +/- 82.6, 112 +/- 80.3, and 102 +/- 37.5 frames, respectively. Patients with suboptimal myocardial perfusion (ex: TMPG <or= 2 or MBG <or= 2 grade) had higher levels of TMPFC. Furthermore, multivariate analysis shows that the TMPFC was an independent predictor for 30-day (P = 0.0261) and 6-month incidence of MACE (P = 0.0207).
  
  
  CONCLUSIONS
  TMPFC is a quantitative index for the assessment of myocardial perfusion; it allows quantification of TMPG and may serve as a discerning tool to predict prognosis in patients undergoing primary angioplasty.
authors: Department of Cardiology, Shanghai Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China.
authors: Song
authors: S
authors: Ding
authors: Jun
authors: J
authors: Pu
authors: Zhi-qing
authors: ZQ
authors: Qiao
authors: Peiren
authors: P
authors: Shan
authors: Wei
authors: W
authors: Song
authors: Yongping
authors: Y
authors: Du
authors: Jie-Yan
authors: JY
authors: Shen
authors: Shu-xuan
authors: SX
authors: Jin
authors: Yu
authors: Y
authors: Sun
authors: Long
authors: L
authors: Shen
authors: Yean-leng
authors: YL
authors: Lim
authors: Ben
authors: B
authors: He
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D002932:Cineangiography; D017023:Coronary Angiography; D003326:Coronary Circulation; D019992:Databases as Topic; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy*; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome