Impact of myocardial blush on left ventricular remodeling after first anterior myocardial infarction treated successfully with primary coronary intervention

Ashraf Hamdan, Ran Kornowski, Eli I. Lev, Alexander Sagie, Shmuel Fuchs, David Brosh, Alexander Battler, Abid R. Assali

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Background: Myocardial blush grade is a useful marker of microvascular reperfusion that may influence left ventricular dilation. Objectives: 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 ≥ 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.

Original languageEnglish
Pages (from-to)211-215
Number of pages5
JournalIsrael Medical Association Journal
Volume12
Issue number4
StatePublished - 1 Jan 2010
Externally publishedYes

Keywords

  • Acute myocardial infarction
  • Blush
  • Microvascular reperfusion
  • Primary percutaneous coronary intervention
  • Remodeling

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