Comparison of TIMI Myocardial Perfusion Grade with Coronary Flow Reserve for Prediction of Recovery of LV Function and LV Remodeling in Acute Myocardial Infarction.
10.4070/kcj.2004.34.3.247
- Author:
So Yeon CHOI
1
;
Seung Jea TAHK
;
Myeong Ho YOON
;
Seung Soo SHIN
;
Hyung Mo YANG
;
Hong Seok LIM
;
Il Hyun CHO
;
Tae Young CHOI
;
Hyuk Jae CHANG
;
Gyo Seung HWANG
;
Joon Han SHIN
;
Byung Il W CHOI
Author Information
1. Department of Cardiology, Ajou University School of Medicine, Suwon, Korea.
- Publication Type:Original Article
- Keywords:
Myocardial infarction;
Stents;
Coronary circulation;
Ventricular remodeling
- MeSH:
Angioplasty;
Cardiac Catheterization;
Cardiac Catheters;
Constriction, Pathologic;
Coronary Circulation;
Echocardiography;
Humans;
Myocardial Infarction*;
Myocardial Ischemia;
Myocardium;
Percutaneous Coronary Intervention;
Perfusion*;
Stents;
Stroke Volume;
Thymidine Monophosphate;
Ventricular Remodeling
- From:Korean Circulation Journal
2004;34(3):247-257
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: The TIMI myocardial perfusion (TMP) grade is known as one of the methods to assess the viability of the myocardium in ischemic heart disease. This study was designed to assess the value of TMP grade itself and to evaluate the correlation with coronary flow reserve (CFR) in the prediction of left ventricular remodeling and functional change after percutaneous coronary intervention (PCI) in acute myocardial infarction (AMI). SUBJECTS AND METHODS: We measured CFR and TMP grade after successful elective PCI (diameter stenosis <0%, and TIMI flow 3) in 83 patients (mean age 55+/-1 years, 18 females) with AMI within 7 days of symptom onset. Left ventricular end diastolic volume index (LVEDVI), left ventricular end systolic volume index (LVESVI), ejection fraction (LVEF), and left ventricular regional wall motion score index (LVRWMSI) were assessed by echocardiography just before and at 9 months after angioplasty (mean 9+/-5 months). RESULTS: Although they had achieved (TIMI 0.021) TIMI 3 flow after successful intervention, 27 of 83 patients (32.5%) had impaired myocardial perfusion. After PCI, angiographic TMP grade was well correlated with CFR measured using Doppler wire (TMP 0/1;1.4+/-0.3, TMP 2;1.9+/-0.6, TMP 3;2.2+/-0.4, rs=0.618, p=0.000). Post-PCI TMP grade was significantly related to the change of LVEDVI (r=0.452, p=0.000), LVESVI (r=0.435, p=0.000), LVEF (r=0.281, p=0.010) and LVRWMSI (r=0.328, p=0.036). CONCLUSION: The TMP grade, a simple angiographic method, might be useful as a predictor of LV volume and functional change in AMI. In the cardiac catheterization laboratory, it could simply replace CFR for the assessment of myocardial viability in patients who receive an elective PCI within 7 days of AMI onset.
