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עמוד בית
Wed, 29.05.24

Original Articles

IMAJ | volume 12

Journal 4, April 2010
pages: 211-215

Impact of Myocardial Blush on Left Ventricular Remodeling After First Anterior Myocardial Infarction Treated with Successful Primary Coronary Intervention

    Summary

    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[1] remodeling in patients undergoing successful primary  PCI³ for first anterior ST elevation myocardial infarction.

    Methods: In 26 consecutive patients MB[2] grade was evaluated immediately after primary PCI[3]. 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[4] treated successfully with primary PCI.

     



    [1] LV = left ventricular
    [2] MB = myocardial blush
    [3] PCI = percutaneous coronary intervention
    [4] STEMI = ST elevation myocardial infarction

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