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Myocardial Blush Grade: To Evaluate Myocardial Viability in Patients With Acute Myocardial Infarction

Faculties of Medicine, Department of Cardiology, Mustafa Kemal University, Hatay, eseyfeli{at}hotmail.com

Adnan Abaci, MD, FESC

Department of Cardiology, Gazi University, Ankara

Mustafa Kula, MD

Department of Nuclear Medicine, Erciyes University Kayseri

Ramazan Topsakal, MD

Department of Cardiology, Erciyes University Kayseri

Namik K. Eryol, MD

Department of Cardiology, Erciyes University Kayseri

Huseyin Arinc, MD

Department of Cardiology, Abant Izzet Baysal University, Bolu, Turkey

Ibrahim Ozdogru, MD

Department of Cardiology, Erciyes University Kayseri

Ali Ergin, MD

Department of Cardiology, Erciyes University Kayseri

Myocardial blush grade (MBG) is used to assess myocardial perfusion in the infarcted myocardium. The purpose of this study was to determine whether the analysis of myocardial blush grade after resolution of the acute phase of myocardial infarction is useful for assessing myocardial viability. The present study is consisted of 64 patients (55 men, mean age 55 ±11 years) who had acute myocardial infarction and nonoccluded stenosis (>50%) in an infarct-related artery. All the patients had thrombolysis in myocardial infarction (TIMI)-3 flow in the infarct-related artery on coronary angiograms. Myocardial viability was determined by single-photon emission computed tomography (SPECT) within the same week after coronary angiograms. MBG 0 in 5 (8%) patients, grade 1 in 10 (16%) patients, grade 2 in 23 (36%) patients, and grade 3 in 26 (40%) patients were present. Fifty-four (84%) of 64 patients showed myocardial viability by SPECT. Myocardial viability was demonstrated in 11 of 15 patients (74%) with MBG 0/1 and 43 of 49 patients (88%) with MBG 2/3. There was a weak relation between MBG and myocardial viability by correlation analysis (r = 0.28, p = 0.025). If MBG 0 and 1 are regarded as a sign of nonviable myocardium, and if MBG 2 and 3 are regarded as a sign of viable myocardium, the sensitivity of MBG for the prediction of myocardial viability was 79%, specificity was 40%, positive predictive value was 88%, and negative predictive value was 27%. MBG has a weak correlation with myocardial viability. Although sensitivity is fairly good, specificity is very low. We concluded that the diagnostic value of MBG is limited to detect myocardial viability in the infarcted region.

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Angiology, Vol. 58, No. 5, 556-560 (2007)
DOI: 10.1177/0003319707307846


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This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Seyfeli, E. Articles by Ergin, A. Search for Related Content PubMed PubMed Citation Articles by Seyfeli, E. Articles by Ergin, A. Pubmed/NCBI databases Medline Plus Health Information Heart Attack Social Bookmarking                         What's this?