1. Evolution of Myocardial Blush after MI
2.8%
Likewise, the risk of dying increases as the frame count increases. Those patients with a CTFC < 14 (hyper-
emic flow, “TIMI Grade 4 flow”) have a very low mortality.
Mean of 7.5 months
Hoffman et al, AJC 2003; 92:

2. Associaiton of Myocardial Blush with LV Function at 4 Weeks
Lepper et al AJC 2001; 88:

3. Evolution of Myocardial Blush after MI
2.8%
Likewise, the risk of dying increases as the frame count increases. Those patients with a CTFC < 14 (hyper-
emic flow, “TIMI Grade 4 flow”) have a very low mortality.
Mean follow-up 7.5 months
Hoffman et al, AJC 2003; 92:

4. Left Ventricular Function in Relation to Evolution of Myocardial Blush
2.8%
LVEF at mean 7.5 months
Likewise, the risk of dying increases as the frame count increases. Those patients with a CTFC < 14 (hyper-
emic flow, “TIMI Grade 4 flow”) have a very low mortality.
Mean follow-up 7.5 months
Hoffman et al, AJC 2003; 92:

5. Jaroslaw Zalewski et al, ACC 2004
Evolution of Thrombolysis in Myocardial Infarction Myocardial Perfusion Grade During Primary Coronary Angioplasty in Acute Myocardial Infarction Predicts Long-Term Recovery of Left Ventricular Function
Reperfusion Pattern
0/1 to 0/1
(I)
n=204
2/3 to 0/1
(II)
n=11
0/1 to 2
(III)
n=133
2/3 to 2
(IV)
n=41
0/1 to 3
(V)
n=122
2/3 to 3
(VI)
n=74
% pts with complete ST resolution
37.3†
36.4†
45.9†
60.9†
52.5†
72.9†
AUC [U/lxh]
3690 ± 1840
3870 ± 1975
2485 ± 882*
2340 ± 837**
2259 ± 954*
2115 ± 810**
EF-24h [%]
42 ± 11†
41 ± 3†
46 ± 9†
45 ± 12†
53 ± 9†
55 ± 8†
EF-6m [%]
39 ± 10†,***
40 ± 3†
45 ± 8†
46 ± 12†
55 ± 9†, ††
59 ± 9†, ***
Conclusion: Maintaining a high MPG throughout PCI in AMI or achieving a marked MPG improvement are both related to improved ST resolution, smaller areas under the curve for myonecrosis, and better ejection fractions acutely and at 6 month follow-up.
*p<0.01 vs. I, **p<0.01 vs. II, †p<0.001 among I-VI, ††p<0.001 vs. I-IV, ***p<0.01 vs. EF-24h
AUC: Area under curve of CK-MB release in the first 48 hours
V – MPG improvement from 0/1 to 3, VI – High MPG maintained (2/3 before and 3 after PCI)
Jaroslaw Zalewski et al, ACC 2004