Abstract 2569: Tissue Doppler Imaging In The Evaluation Of Infarcted Segmental Myocardial Function In Stemi Reperfused Patients: Correlation With Myocardial Blush Grade.
Background: The myocardial blush grade (MBG) during primary-PCI predicts long-term recovery of left ventricular function. Tissue Doppler imaging (TDI) quantitatively assess regional myocardial function by measuring systolic strain (SS). No data are available on the correlation between MBG and the infarcted segmental systolic function by TDI in STEMIpts.
Methods: We evaluated 40 STEMI pts, divided in four groups (MBG 0; MBG 1; MBG 2; MBG 3) 10 pts for each goup. Primary PCI was performed according to current standard guidelines. Coronary angiograms were analyzed off-line by two expert interventional cardiologists in a blinded manner. MBG were estimated visually. Sixteen-segments model was applied and regional myocardial function was evaluated, immediately after primary PCI, by measuring SS by TDI . Only SS value in infarcted segments was correlated with the MBG.
Results: No significative difference was observed between groups except for family history of CAD that was higher in MBG 2 group. Mean ejection fraction (39,1 ± 8,8%) and mean symptoms to balloon time(4.3 ± 1.6 h ) was similar in the population. 136 infarcted segments were studied by TDI. A significant direct correlation between the MBG and the SS (r=0.79; p<0.005) (Fig.1⇓). We also observed a significative difference (p<0.005) between mean SS in pts with MBG ≤0 –1 (7.6 ± 2.4%) and in pts with MBG≥2–3(22.6 ± 5.2).
Conclusions: Abnormal values of SS was observed in infarcted segments. The significant correlation observed between the MBG and SS may demonstrate that MBG represent an important predictive index not only of good reperfusion but also of rapid segmental function recovery; similarly an evaluation of SS after primary PCI could be useful to evaluate if primary percutaneus reperfusion has been effective or not.