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Titolo:
CORONARY REVASCULARIZATION IN THE TREATMENT OF MODERATE AND SEVERE POSTISCHEMIC LEFT-VENTRICULAR DYSFUNCTION
Autore:
FATHORDOUBADI F; PAGANO D; MARINHO NVS; KEOGH BE; BONSER RS; CAMICI PG;
Indirizzi:
UNIV LONDON IMPERIAL COLL SCI TECHNOL & MED,MRC,CYCLOTRON UNIT,HAMMERSMITH HOSP,CANE RD LONDON W12 0NN ENGLAND UNIV LONDON IMPERIAL COLL SCI TECHNOL & MED,MRC,CYCLOTRON UNIT,HAMMERSMITH HOSP LONDON W12 0NN ENGLAND QUEEN ELIZABETH HOSP,CARDIOTHORAC SURG UNIT BIRMINGHAM B15 2TH W MIDLANDS ENGLAND
Titolo Testata:
The American journal of cardiology
fascicolo: 1, volume: 82, anno: 1998,
pagine: 26 - 31
SICI:
0002-9149(1998)82:1<26:CRITTO>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
POSITRON EMISSION TOMOGRAPHY; MYOCARDIAL BLOOD-FLOW; ARTERY DISEASE; FUNCTIONAL RECOVERY; GLUCOSE-UTILIZATION; VIABILITY; ECHOCARDIOGRAPHY; IDENTIFICATION; DOBUTAMINE; TL-201;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
29
Recensione:
Indirizzi per estratti:
Citazione:
F. Fathordoubadi et al., "CORONARY REVASCULARIZATION IN THE TREATMENT OF MODERATE AND SEVERE POSTISCHEMIC LEFT-VENTRICULAR DYSFUNCTION", The American journal of cardiology, 82(1), 1998, pp. 26-31

Abstract

Chronic postischemic left ventricular (LV) dysfunction can improve following coronary revascularization (hibernating myocardium). However, it is not clear whether the severity of LV dysfunction determines functional outcome after revascularization and the accuracy of tests to predict myocardial viability. We studied 47 patients with coronary artery disease and chronic LV dysfunction. Before coronary bypass, patientsunderwent (F-18)2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) during euglycemic hyperinsulinemic clamp to assess viability. Global and regional LV function were assessed before and 4 to 6months after surgery. Patients were arbitrarily divided into 2 groupswith moderate and severe LV dysfunction. Group 1 (n = 26) had an election fraction (EF) of less than or equal to 30% and group 2 (n = 21) >30%. After bypass, the EF (22 +/- 6% vs 31 +/- 10%; p < 0.0001) and global wall motion score (WMS) (2.05 +/- 0.39 vs 1.56 +/- 0.34; p <0.001) improved in group 1, whereas the EF (43 +/- 9% vs 43 +/- 12%; p = NS) was unchanged in group 2, although WMS tended to improve (1.42 +/- 0.38 vs 1.32 +/- 0.39; p = 0.09). The proportion of dysfunctional segments (72% vs 32%; p <0.0001) and FDG uptake in these segments (0.44 +/-0.15 vs 0.34 +/- 0.15 mu mol/g/min, p <0.0001) were greater in group 1 than in group 2. The baseline EF influenced the predictive accuracy of PET, with highest positive predictive accuracy in group 2 and highest negative predictive accuracy in group 1. Thus, coronary revascularization has the potential for greatest benefit in patients with the most severe dysfunction, but with evidence of viability, and the entity of LV dysfunction affects the predictive accuracy of viability studies. (C) 1998 by Excerpta Medico, Inc.

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Documento generato il 27/11/20 alle ore 09:42:33