Myocardial Blushing' Grading Prediction of Myocardial Patients with Chronic Ischemic Heart Diseases | ||||
| Al-Azhar International Medical Journal | ||||
| Volume 2025, Issue 1, January 2025 | ||||
| DOI: 10.58675/2682-339X.2837 | ||||
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| Authors | ||||
| Wessam Omran; Ehab Elhefny; Wael Atia; Mohamed Mossad | ||||
| Department of Cardiovascular, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt | ||||
| Abstract | ||||
| Background: Chronic ischemic heart diseases (CIHD) pose a significant global health burden due to sustained myocardial blood flow impairment. Myocardial blushing, assessed through angiography using grading systems like Thrombolysis In Myocardial Infarction (TIMI) blush grade, has emerged as a potential indicator of microvascular perfusion abnormalities, offering insights into risk stratification and therapeutic decisions. Aim: This study aims to compare the predictive value of Myocardial Blush Grades and dobutamine stress echocardiography in relation to gadolinium-enhanced CMRI for assessing myocardial viability in patients with chronic ischemic heart disease. Methods: A comprehensive analysis was conducted on CIHD patients, categorized based on TIMI Myocardial Perfusion grades. Demographic data, clinical parameters, and various diagnostic assessments, including low-dose dobutamine results, late gadolinium enhancement, viable segments, and quality of life factors, were evaluated. The predictive value of myocardial blushing grading in relation to these parameters was examined. Results: The evaluation of Coronary Angiographic Thrombolysis in Myocardial Infarction (TIMI) flow and Myocardial Blushing grade showed variable predictive values across different coronary arteries. Combined Myocardial Blushing and Dobutamine Stress Echocardiography demonstrated a high diagnostic capability for predicting myocardial viability, with a positive predictive value (PPV) of 84.21%, negative predictive value (NPV) of 93.02%, and sensitivity of 94.12%. When compared to individual modalities, this combined approach offered superior sensitivity and specificity in assessing myocardial viability in CIHD patients. Conclusion: The combined assessment of Myocardial Blushing and Dobutamine Stress Echocardiography provides high diagnostic accuracy for predicting myocardial viability in chronic ischemic heart disease patients. This approach may be more reliable than using individual diagnostic methods alone, suggesting its potential utility in clinical practice for guiding therapeutic decisions in CIHD. Further studies are recommended to validate these findings in larger and more diverse patient populations. | ||||
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