Document Detail


Comparison of the angiographic myocardial blush grade with delayed-enhanced cardiac magnetic resonance for the assessment of microvascular obstruction in acute myocardial infarctions.
MedLine Citation:
PMID:  19626683     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Both myocardial blush grade (MBG) and cardiac magnetic resonance (CMR) are imaging tools that can assess myocardial reperfusion after primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). OBJECTIVES: We studied the relation between MBG and gadolinium-enhanced CMR for the assessment of microvascular obstruction (MVO) in patients with acute ST-elevated myocardial infarction (STEMI) treated by primary PCI. MATERIAL AND METHODS: MBG was assessed in 39 patients with initial TIMI 0 STEMI successfully treated by PCI, resulting in TIMI 3 flow grade and complete ST-segment resolution. These MBG values were related to MVO determined by CMR, performed between 2 and 7 days after PCI. Left ventricular (LV) volumes were determined at baseline and at 6-month follow-up. RESULTS: No statistical relation was found between MBG and MVO extent at CMR (P = 0.63). Regarding MBG 0 and 1 as a sign of MVO, the sensitivity and specificity of these scores were 53.8 and 75%, respectively. In this study, CMR determined MVO was the only significant LV remodeling predicting factor (beta = 31.8; P = 0.002), whatever the MBG status was. CONCLUSION: MBG underestimates MVO after an optimal revascularization in AMI compared with CMR. This study suggests the superior accuracy of delayed-enhanced magnetic resonance over MBG for the assessment of myocardial reperfusion injury that is needed in clinical trials, where the principal endpoint is the reduction of infarct size and MVO.
Authors:
J Vicente; N Mewton; P Croisille; P Staat; E Bonnefoy-Cudraz; M Ovize; D Revel
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  74     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-09     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1000-7     Citation Subset:  IM    
Affiliation:
Radiology Department, Hôpital Cardiovasculaire Louis Pradel, Bron cedex, Hospices Civils de Lyon, France.
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Comment In:
Catheter Cardiovasc Interv. 2009 Dec 1;74(7):1008-9   [PMID:  19953517 ]

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