TIMI flow grade 4: Difference between revisions

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{{Coronary angiography2}}


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{{SK}} TIMI 4, TIMI 4 flow, TIMI 4 flow grade, TFG 4, TFG4, hyperemia, hyperemic flow
==Overview==
TIMI grade 4 flow is a term developed by Dr. [[C. Michael Gibson]], M.S., M.D. to describe [[hyperemic flow]] on a [[coronary arteriogram]].<ref name="pmid18435949">{{cite journal| author=Gibson CM, Pride YB, Buros JL, Kunadian V, Southard MC, Harrigan CJ et al.| title=Relation of hyperemic epicardial flow to outcomes among patients with ST-segment elevation myocardial infarction receiving fibrinolytic therapy. | journal=Am J Cardiol | year= 2008 | volume= 101 | issue= 9 | pages= 1232-8 | pmid=18435949 | doi=10.1016/j.amjcard.2007.12.023 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18435949 }} </ref>  [[Hyperemic flow]] on a coronary arteriogram is defined qualitatitively as near instantaneous filling of the [[coronary artery]] with dye, and quantitatively as a corrected [[TIMI frame count]] < 14 frames. [[Hyperemic flow]] in a coronary artery may be due to either repayment of oxygen debt following ischemia due to a balloon inflation for instance, or [[distal embolization]].  If it is due to [[distal embolization]], and if impaired [[myocardial perfusion]] is present ([[TIMI myocardial perfusion grade 0]] or [[TIMI myocardial perfusion grade 1]]), then the mortality associated with [[TIMI grade 4 flow]] is actually '''higher''' than that of [[TIMI grade 3 flow]].<ref name="pmid18435949">{{cite journal| author=Gibson CM, Pride YB, Buros JL, Kunadian V, Southard MC, Harrigan CJ et al.| title=Relation of hyperemic epicardial flow to outcomes among patients with ST-segment elevation myocardial infarction receiving fibrinolytic therapy. | journal=Am J Cardiol | year= 2008 | volume= 101 | issue= 9 | pages= 1232-8 | pmid=18435949 | doi=10.1016/j.amjcard.2007.12.023 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18435949 }} </ref>  In this scenario, the [[hyperemic flow]] is a surrogate or marker of endogenous [[adenosine]] release due to [[distal embolization]], rather than being causally related to adverse outcomes.


==References==
==References==

Latest revision as of 16:23, 3 May 2014

Coronary Angiography

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: TIMI 4, TIMI 4 flow, TIMI 4 flow grade, TFG 4, TFG4, hyperemia, hyperemic flow

Overview

TIMI grade 4 flow is a term developed by Dr. C. Michael Gibson, M.S., M.D. to describe hyperemic flow on a coronary arteriogram.[1] Hyperemic flow on a coronary arteriogram is defined qualitatitively as near instantaneous filling of the coronary artery with dye, and quantitatively as a corrected TIMI frame count < 14 frames. Hyperemic flow in a coronary artery may be due to either repayment of oxygen debt following ischemia due to a balloon inflation for instance, or distal embolization. If it is due to distal embolization, and if impaired myocardial perfusion is present (TIMI myocardial perfusion grade 0 or TIMI myocardial perfusion grade 1), then the mortality associated with TIMI grade 4 flow is actually higher than that of TIMI grade 3 flow.[1] In this scenario, the hyperemic flow is a surrogate or marker of endogenous adenosine release due to distal embolization, rather than being causally related to adverse outcomes.

References

  1. ↑ 1.0 1.1 Gibson CM, Pride YB, Buros JL, Kunadian V, Southard MC, Harrigan CJ; et al. (2008). "Relation of hyperemic epicardial flow to outcomes among patients with ST-segment elevation myocardial infarction receiving fibrinolytic therapy". Am J Cardiol. 101 (9): 1232–8. doi:10.1016/j.amjcard.2007.12.023. PMID 18435949.
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