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Titolo:
Relation of the contractile reserve of hibernating myocardium to myocardial structure in humans
Autore:
Nagueh, SF; Mikati, I; Weilbaecher, D; Reardon, MJ; Al-Zaghrini, GJ; Cacela, D; He, ZX; Letsou, G; Noon, G; Howell, JF; Espada, R; Verani, MS; Zoghbi, WA;
Indirizzi:
Baylor Coll Med, Cardiol Sect, Dept Med, Houston, TX 77030 USA Baylor CollMed Houston TX USA 77030 ect, Dept Med, Houston, TX 77030 USA
Titolo Testata:
CIRCULATION
fascicolo: 5, volume: 100, anno: 1999,
pagine: 490 - 496
SICI:
0009-7322(19990803)100:5<490:ROTCRO>2.0.ZU;2-8
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY-ARTERY DISEASE; DOSE DOBUTAMINE ECHOCARDIOGRAPHY; EMISSION COMPUTED-TOMOGRAPHY; LEFT-VENTRICULAR FUNCTION; REDISTRIBUTION-REINJECTION; VIABLE MYOCARDIUM; TL-201 TOMOGRAPHY; VIABILITY; DYSFUNCTION; THALLIUM;
Keywords:
hibernation; echocardiography; pathology; scintigraphy;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
23
Recensione:
Indirizzi per estratti:
Indirizzo: Nagueh, SF Baylor Coll Med, Cardiol Sect, Dept Med, 6550 Fannin,SM1246, Houston, TX 77030 USA Baylor Coll Med 6550 Fannin,SM1246 Houston TX USA 77030030 USA
Citazione:
S.F. Nagueh et al., "Relation of the contractile reserve of hibernating myocardium to myocardial structure in humans", CIRCULATION, 100(5), 1999, pp. 490-496

Abstract

Background-Although dobutamine echocardiography (DE) is widely used to assess myocardial viability in humans, little is known about the relation between contractile reserve and myocardial structure. Methods ana Results-We evaluated 20 patients with coronary disease (64+/-13 years old, ejection fraction 28+/-7.5%) with DE (up to 40 mu g.kg(-1).min(-1)), rest-redistribution Tl-201 single photon emission CT, and quantitative angiography before bypass surgery. During surgery, patients underwent transmural myocardial biopsies (n=37) guided by transesophageal echocardiography to determine the extent of interstitial fibrosis and intracellular and interstitial proteins by histopathology and immunohistochemistry. Among the37 segments biopsied, 16 recovered function as assessed 2 to 3 months later. Segments with postoperative functional recovery had more wall thickeningat low-dose DE (28% versus 3%, P<0.001), higher thallium uptake (69% versus 48%, P=0.03), and less interstitial fibrosis (2% versus 28%, P<0.001), Quantitative angiographic parameters did not predict recovery of function. Segments with DE viability (contractile reserve and/or ischemia) had less fibrosis (2.7% versus 28%, P<0.001), less vimentin and fibronectin (both P<0.01), more glycogen (P=0.016), and higher thallium uptake (64% versus 35.5%, P<0.055 than those without viability. Viable segments by both DE and thallium had less fibrosis (1%) than those viable by 1 of the 2 techniques (9%) or not viable by both (28%, P=0.005). Thickening at low-dose DE correlated well with the extent of interstitial fibrosis (r=-0.83, P<0.01). Conclusions-Contractile reserve during DE correlates inversely with the extent of interstitial fibrosis and the amount of fibronectin and vimentin and directly with rest-redistribution thallium uptake.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 31/03/20 alle ore 22:37:45