Can ST-segment recovery and myocardial blush predict prognosis?
Mikael Dellborg
Correspondence Department of Medicine, Sahlgrenska University Hospital/Östra, University of Göteborg, Göteborg, Sweden
Email mikael.dellborg@hjl.gu.se
This article has no abstract so we have provided the first paragraph of the full text.
Over the past 20 years, STR has evolved as a well-validated, simple and efficient method for evaluating the success of reperfusion treatment in patients with acute ST-elevation myocardial infarction (STEMI). The concept is simple: reperfuse the myocardium and ischemia will disappear and ST-elevation will recover. This effect is true provided the artery is opened and the microvascular function is reasonably preserved. The reopening of the vessel without preservation of microvascular integrity, however, yields less-favorable long-term outcomes. Coronary angiography, formerly the golden standard of evaluating reperfusion, lacks the ability to evaluate microvascular function. Several new techniques have been developed for evaluating microvascular function and perfusion, such as Doppler coronary flow reserve and myocardial-contrast echocardiography. MB is a semiquantitative way of analyzing myocardial-contrast appearance when performing angiography. Blush has been suggested to reflect microvascular perfusion in a similar manner to an electrocardiogram.
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