Background. Myocardial blush grade (MBG) is routinely used to assess the effectiveness of myocardial reperfusion in patients with acute myocardial infarction. Impaired MBG has been found to be an independent predictor of outcome after reperfusion therapy. Objectives. To assess the impact of myocardial blush grade on left ventricular remodeling in patients undergoing successful emergency percutaneous coronary intervention (PCI). Methods. The study included 30 consecutive patients with first time acute ST segment elevation myocardial infarction (STEMI). All patients underwent successful emergency percutaneous coronary intervention (PCI). Patients with TIMI flow-III were further submitted to MBG grading. Echocardiography was done at 24hours and 3 months post intervention to assess the impact of MBG on left ventricular remodeling. Results. Eight patients (26.7%) had MBG 0; 7 patients (23.3%) had MBG I; 12 patients (40%) had MBG II, and 3 patients (10%) had MBG III. There was no significant difference between MB grades in baseline characteristics. Chest pain was the main presenting symptom (100%). Time from symptom onset was inversely correlated with MB grades. Remodeling was presented in 11 patients (37%). 75% of patients with grade 0 MBG, 57% of grade I, 8.3% of grade II, and 0% of grade III had ventricular remodeling at 3 months respectively.(p=0.007). Conclusion. Impaired MBG after emergency PCI is associated with increased risk of LV remodeling. It has the advantage of being simple method to assess myocardial microcirculation. |
