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Updated: Jun 20, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Comparison of two visual angiographic perfusion grades in acute myocardial infarction
Tamás Ungi1, Viktor Sasi, Imre Ungi
1Department of Radiology, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.
Insights
TIMI myocardial perfusion grade (TMP) better predicts myocardial recovery after acute myocardial infarction (AMI) than myocardial blush grade (MBG). TMP correlates more strongly with clinical indicators of heart damage and function post-revascularization.
Area of Science:
- Cardiology
- Interventional Cardiology
- Myocardial Perfusion Imaging
Background:
- Epicardial artery patency after revascularization in acute myocardial infarction (AMI) does not guarantee myocardial functional recovery.
- Assessing myocardial perfusion visually involves two grades: myocardial blush grade (MBG) and TIMI myocardial perfusion grade (TMP).
Purpose of the Study:
- To compare the correlation of MBG and TMP with short-term indicators of myocardial damage after successful revascularization in AMI patients.
- To determine which angiographic parameter, MBG or TMP, is a better predictor of myocardial recovery.
Main Methods:
- Sixty-two patients with AMI and successful revascularization were included.
- Myocardial perfusion was assessed using MBG and TMP.
- Short-term indicators of myocardial damage evaluated included enzymatic infarct size (creatine kinase release), left ventricular ejection fraction (LVEF) via echocardiography, and ST-segment resolution (STR).
Main Results:
- TIMI myocardial perfusion grade (TMP) demonstrated a stronger correlation with all clinical parameters: creatine kinase release (CK) (R= -0.687), left ventricular ejection fraction (LVEF) (R=0.586), and ST-segment resolution (STR) (R=0.574).
- Myocardial blush grade (MBG) showed significant correlations with LVEF (R=0.389) and STR (R=0.348), but not with enzymatic infarct size (CK) (R=-0.062).
Conclusions:
- TIMI myocardial perfusion grade (TMP), reflecting dye clearance, is a more characteristic indicator of myocardial recovery post-AMI than myocardial blush grade (MBG), which represents maximal contrast density.
- TMP is a more reliable parameter for assessing functional recovery in clinical practice following AMI revascularization.
Introduction:
Prognosis after opening the obstructed coronary artery in acute myocardial infarction (AMI) is influenced by several factors. In routine clinical practice, revascularization is considered to be successful when the restoration of epicardial blood-flow is complete. However, the patent epicardial artery does not always provide functional recovery in the myocardium. There are two visual angiographic grades to assess myocardial perfusion: myocardial blush grade (MBG) and TIMI myocardial perfusion grade (TMP). The aim of our study was to compare these two parameters, how they correlate with short-term indicators of myocardial damage.
Patients And Methods:
The two visual grades were assessed along with enzymatic infarct size as creatine kinase release (CK), echocardiographic left ventricular ejection fraction (LVEF), and ST-segment resolution (STR) in 62 patients with acute myocardial infarction and successful revascularization.
Results:
Better correlation was found with TMP in case of all clinical parameters (CK: R= - 0.687, P<0.001; LVEF: R=0.586, P<0.001; STR: R=0.574, P<0.001). MBG also showed significant correlations with clinical measurements, except for enzymatic infarct size (CK: R=- 0.062, P=0.626; LVEF: R=0.389, P=0.002; STR: R=0.348, P=0.006).
Conclusion:
Our findings suggest that the clearance of the dye (described by TMP) is more characteristic to myocardial recovery after AMI, than maximal contrast density (described by MBG) in the clinical practice.
