Tomasik Andrzej, Młyńczak Tomasz, Nowak Edyta, Pigoń Katarzyna, Iwasieczko Artur, Opara Mariusz, Nowalany-Kozielska Ewa
2nd Department of Cardiology in Zabrze, Medical Faculty with Dentistry Division in Zabrze, Medical University of Silesia, Katowice, Poland.
Students' Scientific Group at 2nd Department of Cardiology in Zabrze, Medical Faculty with Dentistry Division in Zabrze, Medical University of Silesia, Katowice, Poland.
Cardiol J. 2019;26(4):322-332. doi: 10.5603/CJ.a2017.0129. Epub 2017 Nov 13.
Acute myocardial infarction (AMI) might lead to left ventricular remodeling. Adequate myocardial perfusion is critical to prevent this adverse remodeling. Quantitative myocardial blush evaluator (QuBE) software, available on-line, is a simple analysis tool which enables the precise quan-tification of myocardial perfusion in the infarct area immediately after interventional treatment. The aim of this study was to assess whether the results of QuBE analysis might predict the development of heart failure (HF) in AMI patients in 3 year-long follow-up.
Ninety five patients with first AMI, single vessel coronary artery disease, Killip class I at presentation were enrolled in the study. Angiograms were reanalyzed using the on-line QuBE software. Data on heart failure development (ICD 10 codes I50) provided by the National Health Fund were considered as primary outcome.
QuBE values ranged from 0.0 to 25.3 arbitrary units, mean value was 9.9 ± 5.2 arbitrary units. QuBE correlated positively with myocardial blush grade (MBG; Spearman R = 0.342 at p < 0.05). Multivariate Cox proportional hazard modeling, adjusted for initial Thrombolysis in Myocardial In-farction (TIMI flow, and TIMI thrombus grade indicated QuBE score (1 unit increase - HR 0.919, 95% CI 0.846-0.999, p = 0.049) and left ventricular ejection fraction at discharge (1% increase - HR 0.936, 95% CI 0.902-0.971, p = 0.000) as independent predictors of HF development.
The QuBE assessment of myocardial perfusion allows the prediction of HF development in the post-infarction period in this highly selective group of patients.
急性心肌梗死（AMI）可能导致左心室重构。充足的心肌灌注对于预防这种不良重构至关重要。定量心肌造影评估器（QuBE）软件可在线获取，是一种简单的分析工具，能够在介入治疗后立即精确量化梗死区域的心肌灌注。本研究的目的是评估QuBE分析结果是否能预测AMI患者在3年随访期内心力衰竭（HF）的发生。
95例首次发生AMI、单支冠状动脉疾病且就诊时Killip分级为I级的患者纳入本研究。使用在线QuBE软件重新分析血管造影图像。将国家卫生基金提供的心力衰竭发生数据（国际疾病分类第10版代码I50）视为主要结局。
QuBE值范围为0.0至25.3任意单位，平均值为9.9±5.2任意单位。QuBE与心肌造影分级（MBG）呈正相关（Spearman相关系数R = 0.342，p < 0.05）。多变量Cox比例风险模型，校正初始心肌梗死溶栓治疗（TIMI）血流和TIMI血栓分级后，显示QuBE评分（每增加1单位 - 风险比0.919，95%置信区间0.846 - 0.999，p = 0.049）和出院时左心室射血分数（每增加1% - 风险比0.936，95%置信区间0.902 - 0.971，p = 0.000）是HF发生的独立预测因素。
在这一高度选择性的患者群体中，QuBE对心肌灌注的评估能够预测梗死后时期HF的发生。
