The beneficial effect of revascularization on jeopardized myocardium: reverse remodeling and improved long-term prognosis.
Eur J Cardiothorac Surg
; 22(3): 426-30, 2002 Sep.
Article
em En
| MEDLINE
| ID: mdl-12204735
ABSTRACT
OBJECTIVES:
To evaluate the impact of viability/ischemia before revascularization on improvement in systolic performance, reverse remodeling, symptoms and long-term prognosis post-revascularization.METHODS:
Fifty patients underwent thallium-201 imaging before revascularization to assess stress-induced ischemia and viability ('jeopardized myocardium'). Left ventricular (LV) ejection fraction (EF), LV end-systolic volume index (LVESVI) and LV end-diastolic volume index (LVEDVI) were determined before and 3 months post-revascularization. Graft/vessel patency was controlled by repeat angiography. Long-term follow-up data (New York Heart Association (NYHA) class, hard events) were acquired up to 3 years.RESULTS:
Patients with > or = 5 jeopardized segments on thallium-201 imaging demonstrated improvement of LVEF at 3 months (from 35+/-6 to 43+/-6%, P<0.001), with reverse remodeling (LVESVI decreased from 68+/-16 to 52+/-14 ml/m(2), P<0.001; LVEDVI decreased from 103+/-21 to 91+/-18 ml/m(2), P<0.001), and improved in NYHA class with excellent long-term prognosis (0% event rate). Conversely, patients with <5 jeopardized segments failed to improve in LVEF (34+/-4 vs. 33+/-7%, NS), and exhibited ongoing remodeling (LVESVI increased from 70+/-14 to 78+/-23 ml/m(2), P<0.001; LVEDVI increased from 106+/-19 to 116+/-25 ml/m(2), P<0.001), without improvement in NYHA class, and worse long-term prognosis (29% event rate).CONCLUSION:
Patients with jeopardized myocardium benefit from revascularization with improvement in LVEF, reverse remodeling, improvement in NYHA class and favorable long-term prognosis.
Buscar no Google
Base de dados:
MEDLINE
Assunto principal:
Doença das Coronárias
/
Revascularização Miocárdica
Idioma:
En
Ano de publicação:
2002
Tipo de documento:
Article