Journal 4, April 2010pages: 211-215
Background: Myocardial blush grade is a useful marker of microvascular reperfusion that may influence left ventricular dilatation.
Objectives: To assess the impact of myocardial blush grade on LV remodeling in patients undergoing successful primary PCI³ 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 ml vs. 115.2 ± 26) 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.
 LV = left ventricular
 MB = myocardial blush
 PCI = percutaneous coronary intervention
 STEMI = ST elevation myocardial infarction