title: Impact of myocardial blush on left ventricular remodeling after first anterior myocardial infarction treated successfully with primary coronary intervention.
abstract: 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.
authors.affiliation: Cardiac Catheterization Laboratories, Department of Cardiology, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Hamdan
authors.forename: Ran
authors.initials: R
authors.lastname: Kornowski
authors.forename: Eli I
authors.initials: EI
authors.lastname: Lev
authors.forename: Alexander
authors.initials: A
authors.lastname: Sagie
authors.forename: Shmuel
authors.initials: S
authors.lastname: Fuchs
authors.forename: David
authors.initials: D
authors.lastname: Brosh
authors.forename: Alexander
authors.initials: A
authors.lastname: Battler
authors.forename: Abid R
authors.initials: AR
authors.lastname: Assali
mesh_terms: 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