Quantitative assessment of myocardial perfusion using time-density curve analysis after elective percutaneous coronary intervention.
The aim of this study was to assess myocardial blush (MB) using a novel software algorithm that quantifies time-density curves (TDC) after percutaneous coronary intervention (PCI).


METHODS
Thirty-two patients referred for elective PCI were enrolled. TDC curves were generated and mean maximal myocardial contrast density (Dmax) was calculated from 5 regions of interest in the PCI territory. Dmax was normalized to contrast injected in the proximal coronary artery (DI).


RESULTS
Mean DI significantly increased after PCI in all subjects. Dmax correlated directly with subjective grading of Thrombolysis in Myocardial Infarction (TIMI) myocardial blush (R=0.47; P<.01). In 7 subjects referred for PCI of a chronic total occlusion (CTO), mean DI remained increased after PCI. Mean DI was lower in CTO versus non-CTO subjects; however, fold-improvement was higher after PCI of CTO lesions.


CONCLUSIONS
Quantifying MB using TDC analysis is feasible and correlates with subjective MB grading. The clinical utility of MB quantitation after PCI requires further study.
Molecular Cardiology Research Institute, Division of Cardiology, Tufts Medical Center, 800 Washington Street, Box #80, Boston, MA 02111 USA. Nkapur@tuftsmedicalcenter.org.
Michele
M
Esposito
Nimish N
NN
Shah
Ravikiran
R
Korabathina
Chris
C
Pan
Vikram
V
Paruchuri
John
J
Finley
Ameer
A
Shah
Andrew
A
Boyle
Regis
R
Vaillant
Carey D
CD
Kimmelstiel
Navin K
NK
Kapur
D000368:Aged; D000465:Algorithms; D016022:Case-Control Studies; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000502:physiology; D023921:Coronary Stenosis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011379:Prognosis; D012039:Regional Blood Flow / Q000502:physiology*; D012984:Software; D016896:Treatment Outcome