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Titolo:
Clinical benefit of noninvasive viability studies of patients with severe ischemic left ventricular dysfunction
Autore:
Soto, JR; Beller, GA;
Indirizzi:
Univ Virginia, Dept Med, Cardiovasc Div, Charlottesville, VA 22908 USA Univ Virginia Charlottesville VA USA 22908 Charlottesville, VA 22908 USA
Titolo Testata:
CLINICAL CARDIOLOGY
fascicolo: 6, volume: 24, anno: 2001,
pagine: 428 - 434
SICI:
0160-9289(200106)24:6<428:CBONVS>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY-ARTERY DISEASE; EMISSION COMPUTED-TOMOGRAPHY; DOBUTAMINE STRESS ECHOCARDIOGRAPHY; CHRONIC MYOCARDIAL HIBERNATION; LONG-TERM SURVIVAL; VIABLE MYOCARDIUM; TC-99M SESTAMIBI; PROGNOSTIC VALUE; BYPASS SURGERY; CONTRACTILE RESERVE;
Keywords:
coronary artery disease; left ventricular dysfunction; myocardial perfusion imaging; myocardial viability; radionuclide imaging; technetium-99m; thallium-201;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
55
Recensione:
Indirizzi per estratti:
Indirizzo: Beller, GA Univ Virginia, Dept Med, Cardiovasc Div, POB 800158, Charlottesville, VA 22908 USA Univ Virginia POB 800158 Charlottesville VA USA 22908 22908 USA
Citazione:
J.R. Soto e G.A. Beller, "Clinical benefit of noninvasive viability studies of patients with severe ischemic left ventricular dysfunction", CLIN CARD, 24(6), 2001, pp. 428-434

Abstract

The population of patients who have congestive heart failure of ischemic origin is large and growing. It imposes a heavy burden on human suffering and economic costs such as the chronic use of costly medications, recurrent hospital admissions, and, eventually, death or the necessity of heart transplantation. Therefore, the development of methods for detecting viable myocardium may allow the accurate selection of those patients with coronary artery disease with severe left ventricular dysfunction who are most likely to benefit from revascularization, but also excludes patients who are unlikelyto obtain any improvement with revascularization techniques. The presence of reversible dysfunctional myocardium that may improve after revascularization implies the concepts of stunned and hibernating myocardium. Recent evidence suggests that hibernation may not be a stable condition since it might evolve toward an irreversible dysfunction if it is not revascularized at the right moment. The techniques available for viability studies are single-photon emission computed tomography using thallium-201 or compounds labeled with technetium-99m, positron emission tomography, and dobutamine stress echocardiography. Newer and promising techniques are magnetic resonance imaging and contrast echocardiography, whose definitive roles are not clear yet. There is abundant evidence from several important studies showing that patients with a significant amount of viable myocardium have a poor outcome if they are treated medically. Conversely, if these patients are revascularized, their outcomes improve and their symptoms significantly decrease, with less necessity of medication, fewer admissions to the hospital, and even in some cases avoiding heart transplantation. On the other hand, patients with poor or no viability who are revascularized do not obtain significant benefit.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 07/04/20 alle ore 22:38:26