Department of Cardiology, University Medical Center Groningen, University of Groningen, The Netherlands.
Catheter Cardiovasc Interv. 2011 Feb 1;77(2):174-81. doi: 10.1002/ccd.22665.
We investigated whether the Quantitative Blush Evaluator (QuBE) value predicts functional and contrast-enhanced cardiovascular magnetic resonance (CMR) outcomes at 4-6 months after primary percutaneous coronary intervention (PCI) inpatients with ST-segment elevation myocardial infarction (STEMI).
QuBEis a computer-assisted open source program to quantify myocardial reperfusion.Although a higher QuBE value is associated with improved myocardial reperfusion measures and lower 1-year mortality, the association with intermediate functional parameters after STEMI has not yet been investigated.
QuBE values were quantified retrospectively on angiograms of patients enrolled in the ancillary CMR study of the proximal embolic protection in acute myocardial infarction and resolution of ST-elevation trial. QuBE en CMR outcomes were independently assessed by reviewers blinded to clinical data.
A higher QuBE value was significantly associated with a smaller left ventricular (LV) end-diastolic and end-systolic volume, a higher LV ejection fraction and systolic wall thickening in the infarct area, and a smaller final infarct size and extent of transmural segments (P ≤ 0.008). In a multivariable model, including age, gender, infarct location, time to treatment, history of myocardial infarction, and postprocedural thrombolysis in myocardial infarction flow grade,only the QuBE value and infarct location remained as independent predictors of LV ejection fraction (P 5 0.018 for QuBE value).
Higher QuBE values are independently associated with improved functional and contrast-enhanced CMR outcomes including LV ejection fraction at 4-6 months after primary PCI and may therefore aid in identifying high-risk patients who benefit most from adjunctive therapies sustaining myocardial function after PCI.
我们旨在研究在 ST 段抬高型心肌梗死（STEMI）患者行直接经皮冠状动脉介入治疗（PCI）后 4-6 个月时，定量红晕评估器（QuBE）值是否可以预测其功能和对比增强心血管磁共振（CMR）结局。
QuBE 是一种计算机辅助的开源程序，用于定量评估心肌再灌注。虽然 QuBE 值越高与改善心肌再灌注测量和降低 1 年死亡率相关，但与 STEMI 后中间功能参数的关联尚未得到研究。
我们回顾性地在入选急性心肌梗死近端栓塞保护和 ST 段抬高缓解试验的辅助 CMR 研究中的患者的血管造影图像上量化了 QuBE 值。QuBE 值和 CMR 结局由对临床数据盲法评估的审阅者独立评估。
较高的 QuBE 值与较小的左心室（LV）舒张末期和收缩末期容积、较高的 LV 射血分数和梗死区的收缩壁增厚以及较小的最终梗死面积和透壁节段范围显著相关（P≤0.008）。在包括年龄、性别、梗死部位、治疗时间、心肌梗死史和经皮冠状动脉介入治疗后血栓溶解分级的多变量模型中，仅 QuBE 值和梗死部位仍然是 LV 射血分数的独立预测因素（QuBE 值 P=0.018）。
较高的 QuBE 值与 4-6 个月后行直接 PCI 的患者的功能和对比增强 CMR 结局（包括 LV 射血分数）的改善独立相关，因此可能有助于识别最受益于辅助治疗以维持 PCI 后心肌功能的高危患者。
