IMPACT OF MYOCARDIAL BLUSH ON LEFT VENTRICULAR REMODELING IN PATIENTS TREATED SUCCESSFULLY WITH PRIMARY OR RESCUE CORONARY INTERVENTION

Abstract

Myocardial blush grade (MBG) in patients treated successful primary or rescue percutaneous coronary intervention (PCI) for anterior ST elevation myocardial infarction (STEMI) is a good indicator of microvascular reperfusion that may impact left ventricular (LV) remodeling.
Methods: this study included 60 consecutive patients suffered from anterior STEMI whom primary or rescue PCI were done , we evaluate MBG after primary or rescue PCI immediately . For each patient transthoracic echocardiography was done at 24 hours and repeat after 6 months after PCI for evaluation of LV function and volumes.
Results: patients with myocardial reperfusion MBG ( II-III) after primary or rescue PCI was associated with a highly significantly lower rate of remodeling than the absence of myocardial reperfusion MBG (0-1) (12.1% vs. 75 %, P <0.001). also, after 6 months, patients with MBG ( II-III) had significantly smaller LV end-diastolic volume (99 ± 23 vs. 113 ± 27 ml) compared with patients with MBG (0-1). LV remodeling was defined as an increase in end-diastolic volume (LVED) by more than 20%.
Conclusions: Microvascular reperfusion impairment , that assessed by MBG (0-1) in patients with STEMI treated successfully with primary or rescue PCI may be associated with LV dilatation and remodeling.
Keywords: myocardial blush, remodeling ,acute myocardial infarction, primary ,rescue, percutaneous coronary intervention, microvascular reperfusion.
Abbreviations: LV = left ventricular,MB = myocardial blush, PCI = percutaneous coronary intervention ,STEMI = ST elevation myocardial infarction