Quantitative assessment of myocardial perfusion using time-density curve analysis after elective percutaneous coronary intervention

J Invasive Cardiol. 2014 Feb;26(2):60-3.

Abstract

The aim of this study was to assess myocardial blush (MB) using a novel software algorithm that quantifies time-density curves (TDC) after percutaneous coronary intervention (PCI).

Methods: Thirty-two patients referred for elective PCI were enrolled. TDC curves were generated and mean maximal myocardial contrast density (Dmax) was calculated from 5 regions of interest in the PCI territory. Dmax was normalized to contrast injected in the proximal coronary artery (DI).

Results: Mean DI significantly increased after PCI in all subjects. Dmax correlated directly with subjective grading of Thrombolysis in Myocardial Infarction (TIMI) myocardial blush (R=0.47; P<.01). In 7 subjects referred for PCI of a chronic total occlusion (CTO), mean DI remained increased after PCI. Mean DI was lower in CTO versus non-CTO subjects; however, fold-improvement was higher after PCI of CTO lesions.

Conclusion: Quantifying MB using TDC analysis is feasible and correlates with subjective MB grading. The clinical utility of MB quantitation after PCI requires further study.

MeSH terms

  • Aged
  • Algorithms*
  • Case-Control Studies
  • Coronary Angiography
  • Coronary Circulation / physiology
  • Coronary Stenosis / diagnosis
  • Coronary Stenosis / physiopathology
  • Coronary Stenosis / therapy*
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / physiopathology*
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Perfusion Imaging / methods*
  • Percutaneous Coronary Intervention / methods*
  • Prognosis
  • Regional Blood Flow / physiology*
  • Software
  • Treatment Outcome