Quantitative myocardial blush score (QuBE) allows the prediction of heart failure development in long-term follow-up in patients with st-segment elevation myocardial infarction: Proof of concept study

Abstract

Background: 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 quantification 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. Methods: 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. Results: 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 Infarction (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. Conclusions: The QuBE assessment of myocardial perfusion allows the prediction of HF development in the post-infarction period in this highly selective group of patients.