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Titolo:
Functional recovery after coronary artery bypass grafting in patients withsevere left ventricular dysfunction and preserved myocardial viability in the left anterior descending arterial territory as assessed by thallium-201myocardial perfusion imaging
Autore:
Chikamori, T; Hirose, K; Hamada, T; Hitomi, N; Kitaoka, H; Yabe, T; Furuno, T; Seo, H; Yamashiro, T; Doi, Y;
Indirizzi:
Kochi Med Sch, Dept Med & Geriatr, Cardiol Sect, Nankoku, Kochi 7838505, Japan Kochi Med Sch Nankoku Kochi Japan 7838505 , Nankoku, Kochi 7838505, Japan Kochi Med Sch, Dept Surg 2, Nankoku, Kochi 7838505, Japan Kochi Med Sch Nankoku Kochi Japan 7838505 , Nankoku, Kochi 7838505, Japan
Titolo Testata:
JAPANESE CIRCULATION JOURNAL-ENGLISH EDITION
fascicolo: 10, volume: 63, anno: 1999,
pagine: 752 - 758
SICI:
0047-1828(199910)63:10<752:FRACAB>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
POSITRON EMISSION TOMOGRAPHY; DOBUTAMINE ECHOCARDIOGRAPHY; VIABLE MYOCARDIUM; CONTRAST ECHOCARDIOGRAPHY; STRESS ECHOCARDIOGRAPHY; ISCHEMIC CARDIOMYOPATHY; HIBERNATING MYOCARDIUM; EJECTION FRACTION; REVASCULARIZATION; DISEASE;
Keywords:
coronary artery bypass grafting; left ventricular function; myocardial viability; thallium-201 myocardial imaging;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
29
Recensione:
Indirizzi per estratti:
Indirizzo: Chikamori, T Kochi Med Sch, Dept Med & Geriatr, Cardiol Sect, Oko Cho, Nankoku, Kochi 7838505, Japan Kochi Med Sch Oko Cho Nankoku Kochi Japan 7838505 8505, Japan
Citazione:
T. Chikamori et al., "Functional recovery after coronary artery bypass grafting in patients withsevere left ventricular dysfunction and preserved myocardial viability in the left anterior descending arterial territory as assessed by thallium-201myocardial perfusion imaging", JPN CIRC J, 63(10), 1999, pp. 752-758

Abstract

To evaluate the functional recovery after coronary bypass surgery in patients with severe left ventricular (LV) dysfunction (ejection fraction (EF) less than or equal to 35%), 100 consecutive patients with viable myocardium in the territory supplied by the left anterior descending artery (LAD) underwent coronary bypass grafting. In addition, cardiac catheterization and single-photon emission computed tomography (SPECT) perfusion imaging with thallium-201 were repeated 1-year postoperatively. Although 12 patients with severe LV dysfunction were preoperatively in a worse New York Heart Association functional class (3.1+/-0.7 vs 2.4+/-0.8; p<0.01), had a higher incidence of heart failure (10/12 vs 14/88; p<0.001) and had a worse LVEF (29+/-5 vs 61+/-14%; p<0.001) compared with 88 patients without: severe LV dysfunction, the operative mortality was similar in the 2 groups (1/12 vs 2/88; p=NS). The postoperative NYHA functional class in the patients with severe LV dysfunction was similar to that in the patients without such dysfunction (1.6+/-0.7 vs 1.3+/-0.6; p=NS). In addition, the 1-year postoperative study revealed a significant improvement in the thallium defect score in both the LAD territory (1.7+/-1.2 to 0.7+/-1.0, p=0.01) and all the territories (5.2/-2.2 to 3.2+/-1.9, p=0.002) in patients with severe LV dysfunction, whereas no improvement in defect score was found in either of these territories in those without severe LV dysfunction (LAD: 0.6+/-1.4 to 0.4+/-1.2, p=NS; All: 1.9+/-2.2 to 1.8+/-2.0, p=NS). Furthermore, a marked 1-year postoperative improvement (15-24%; 95% confidence interval) in LVEF (29+/-5 to 48+/-10%, p<0.001) was demonstrated in patients with severe LV dysfunction, but not in those without such dysfunction (60+/-13 to 61+/-11%, p=NS) These results indicate that myocardial viability in the LAD territory, as demonstrated by thallium-201 SPECT perfusion imaging, predicts a significant improvement in functional class and LVEF of at least 10% or more after coronary artery bypass grafting in patients with severe LV dysfunction.

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Documento generato il 28/03/20 alle ore 09:53:03