Impact of myocardial blush on left ventricular remodeling after first anterior myocardial infarction treated successfully with primary coronary intervention.
BACKGROUND
Myocardial blush grade is a useful marker of microvascular reperfusion that may influence left ventricular dilation.


OBJECTIVE
To assess the impact of MB grade on LV remodeling in patients undergoing successful primary PCI for first anterior ST elevation myocardial infarction.


METHODS
In 26 consecutive patients MB grade was evaluated immediately after primary PCI. Each patient underwent transthoracic echocardiography at 24 hours and 6 months after PCI for evaluation of LV volumes. LV remodeling was defined as an increase in end-diastolic volume by > or = 20%.


RESULTS
The presence of myocardial reperfusion (MB 2-3) after primary PCI was associated with a significantly lower rate of remodeling than the absence of myocardial reperfusion (MB 0-1) (17.6% vs. 66.6%, P = 0.012). Accordingly, at 6 months, patients with MB 2-3 had significantly smaller LV end-diastolic volume (94 +/- 21.5 vs. 115.2 +/- 26 ml) compared with patients with MB 0-1. In univariate analysis, only MB (0-1 versus 2-3) was associated with increased risk of LV remodeling (odds ratio 9.3, 95% confidence interval 1.45-60.21, P = 0.019).


CONCLUSIONS
Impaired microvascular reperfusion, as assessed by MB 0-1, may be associated with LV remodeling in patients with STEMI treated successfully with primary PCI.
Hamdan
Ashraf
A
Cardiac Catheterization Laboratories, Department of Cardiology, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel.
Kornowski
Ran
R
Lev
Eli I
EI
Sagie
Alexander
A
Fuchs
Shmuel
S
Brosh
David
D
Battler
Alexander
A
Assali
Abid R
AR
D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D017023:Coronary Angiography / Q000379:methods; D003326:Coronary Circulation; D004452:Echocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D016017:Odds Ratio; D020257:Ventricular Remodeling