IMPACT OF MYOCARDIAL BLUSH ON LEFT VENTRICULAR REMODELING IN PATIENTS TREATED SUCCESSFULLY WITH PRIMARY OR RESCUE CORONARY INTERVENTION

Background: Myocardial blush grade (MBG) in patients treated successful primary or rescue percutaneous coronary intervention (PCI) for anterior ST elevation myocardial infarction (STEMI) is a good indicator of microvascular reperfusion that may impact left ventricular (LV) remodeling. Methods: this study included 60 consecutive patients suffered from anterior STEMI whom primary or rescue PCI were done , we evaluate MBG after primary or rescue PCI immediately . For each patient transthoracic echocardiography was done at 24 hours and repeat after 6 months after PCI for evaluation of LV function and volumes. Results: patients with myocardial reperfusion MBG ( II-III) after primary or rescue PCI was associated with a highly significantly lower rate of remodeling than the absence of myocardial reperfusion MBG (0-1) (12.1% vs. 75 %, P <0.001). also, after 6 months, patients with MBG ( II-III) had significantly smaller LV end-diastolic volume (99 ± 23 vs. 113 ± 27 ml) compared with patients with MBG (0-1). LV remodeling was defined as an increase in end-diastolic volume (LVED) by more than 20%. Conclusions: Microvascular reperfusion impairment , that assessed by MBG (0-1) in patients with STEMI treated successfully with primary or rescue PCI may be associated with LV dilatation and remodeling.