Thrombolysis in Myocardial Infarction (TIMI) Flow and Myocardial Blush (MB) as Predictors of Left Ventricular Ejection Fraction Improvement in Patients with Acute Myocardial Infarction with ST Segment Elevation Undergoing Primary Percutaneous Coronary Intervention
Putu Giani Anabella Bestari Putri*, I Kadek Susila Surya Darma, Ida Bagus Rangga Wibhuti
Abstract
Background: Reperfusion success in ST-elevation myocardial infarction (STEMI) is often measured by macrovascular TIMI flow. However, myocardial tissue perfusion, assessed via Myocardial Blush (MB), may provide a more accurate prognosis. This study evaluates TIMI flow and MB as predictors of Left Ventricular Ejection Fraction (LVEF) improvement in STEMI patients post-Primary Percutaneous Coronary Intervention (PCI). Methods: This prospective cohort study included STEMI patients undergoing PCI. TIMI flow and MB (using QuBE software) were measured post-procedure. LVEF was evaluated at baseline and 2-month follow-up. Data were analyzed using Chi-square for Relative Risk (RR) and Cox regression for Adjusted RR. Results: High MB (QuBE ≥9 AU) was a significant independent predictor of LVEF improvement. Patients with high MB had a 1.6 times greater chance of functional recovery compared to those with low MB (RR 1.60; 95% CI 1.21–2.11; p<0.001). Conversely, TIMI flow grade, clinical risk factors (age, diabetes, hypertension), and total ischemic time showed no significant association with LVEF improvement (p>0.05). Multivariate analysis confirmed high MB as the sole independent predictor of LVEF recovery (Adjusted RR 1.57; 95% CI 1.04–2.63; p=0.045). Conclusion: Microvascular perfusion (MB), rather than macrovascular flow (TIMI), is the primary determinant of left ventricular functional recovery post-PCI. Achieving successful reperfusion at the myocardial tissue level is critical for long-term cardiac improvement.
Keywords
acute myocardial infarction; myocardial blush; TIMI flow; LVEF
Cite This Article
Putri, P. G. A. B., Darma, I. K. S. S., Wibhuti, I. B. R. (2026). Thrombolysis in Myocardial Infarction (TIMI) Flow and Myocardial Blush (MB) as Predictors of Left Ventricular Ejection Fraction Improvement in Patients with Acute Myocardial Infarction with ST Segment Elevation Undergoing Primary Percutaneous Coronary Intervention. International Journal of Scientific Advances (IJSCIA), Volume 7| Issue 1: Jan – Feb 2026, Pages 100-109 URL: https://www.ijscia.com/wp-content/uploads/2026/01/Volume7-Issue1-Jan-Feb-No.1022-100-109.pdf
Volume 7 | Issue 1: Jan – Feb 2026
