TIMI myocardial perfusion frame count: a new method to assess myocardial perfusion and its predictive value for short-term prognosis.
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.
Ding
Song
S
Department of Cardiology, Shanghai Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China.
Pu
Jun
J
Qiao
Zhi-qing
ZQ
Shan
Peiren
P
Song
Wei
W
Du
Yongping
Y
Shen
Jie-Yan
JY
Jin
Shu-xuan
SX
Sun
Yu
Y
Shen
Long
L
Lim
Yean-leng
YL
He
Ben
B
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