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Insights into the Pathophysiology of Acute Ischemic Syndromes Using the TIMI Flow Grade, TIMI Frame Count, and TIMI Myocardial Perfusion Grade

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Management of Acute Coronary Syndromes

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

For over a decade now, the Thrombolysis in Myocardial Infarction (TIMI) flow grade classification scheme has been successfully used to assess coronary blood flow in acute coronary syndromes (1). Although this scheme has been a valuable tool for comparing the efficacy of reperfusion strategies and in identifying patients at higher risk for adverse outcomes in acute coronary syndromes, there are limitations to this classification scheme (2,3). To overcome these limitations, the TIMI Angiographic Core Laboratory developed a new index of coronary blood flow called the TIMI frame count (2). In contrast to the TIMI flow grades (TFGs), which are subjective categorical variables, the TIMI frame count is an objective continuous variable of epicardial flow (2). There has also been a recent shift toward focus on microvascular perfusion. One method developed to assess tissue level perfusion is the TIMI myocardial perfusion grade (TMPG) (4). The goal of this chapter is to review these three methods and to discuss the insights into the pathophysiology of acute coronary syndromes provided by these indexes of coronary blood flow and myocardial perfusion.

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Authors
  1. C. Michael Gibson MS, MD
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  2. Sabina A. Murphy MPH
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  3. Jeffrey J. Popma MD
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Editors and Affiliations

  1. Cardiovascular Division, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Christopher P. Cannon MD (Associate Professor of Medicine) (Associate Professor of Medicine)

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Gibson, C.M., Murphy, S.A., Popma, J.J. (2003). Insights into the Pathophysiology of Acute Ischemic Syndromes Using the TIMI Flow Grade, TIMI Frame Count, and TIMI Myocardial Perfusion Grade. In: Cannon, C.P. (eds) Management of Acute Coronary Syndromes. Contemporary Cardiology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-351-4_4

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  • DOI: https://doi.org/10.1007/978-1-59259-351-4_4

  • Publisher Name: Humana Press, Totowa, NJ

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