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Titolo:
Milrinone echocardiographic viability test: A pilot study
Autore:
Dhar, SC; Birnbaum, Y; Hayes, S; Naqvi, T; Cercek, B; Blanche, C; Friedman, A; Trento, A; Siegel, RJ;
Indirizzi:
Cedars Sinai Med Ctr, Div Cardiol, Cardiac Noninvas Lab, Dept Med, Los Angeles, CA 90048 USA Cedars Sinai Med Ctr Los Angeles CA USA 90048 , Los Angeles, CA 90048 USA Cedars Sinai Med Ctr, Dept Cardiothorac Surg, Los Angeles, CA 90048 USA Cedars Sinai Med Ctr Los Angeles CA USA 90048 , Los Angeles, CA 90048 USA Cedars Sinai Med Ctr, Dept Anesthesiol, Los Angeles, CA 90048 USA Cedars Sinai Med Ctr Los Angeles CA USA 90048 , Los Angeles, CA 90048 USA Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA Univ Calif Los Angeles Los Angeles CA USA , Sch Med, Los Angeles, CA USA
Titolo Testata:
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY
fascicolo: 7, volume: 14, anno: 2001,
pagine: 668 - 675
SICI:
0894-7317(200107)14:7<668:MEVTAP>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
LEFT-VENTRICULAR FUNCTION; LOW-DOSE DOBUTAMINE; CORONARY-ARTERY DISEASE; POSITRON EMISSION TOMOGRAPHY; ACUTE MYOCARDIAL-INFARCTION; CONGESTIVE HEART-FAILURE; REDISTRIBUTION TL-201 TOMOGRAPHY; WALL-MOTION ABNORMALITIES; TRANSESOPHAGEAL ECHOCARDIOGRAPHY; INTRAVENOUS MILRINONE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
52
Recensione:
Indirizzi per estratti:
Indirizzo: Siegel, RJ Cedars Sinai Med Ctr, Div Cardiol, Cardiac Noninvas Lab, Dept Med, Room 5335,8700 Beverly Blvd, Los Angeles, CA 90048 USA Cedars Sinai MedCtr Room 5335,8700 Beverly Blvd Los Angeles CA USA 90048
Citazione:
S.C. Dhar et al., "Milrinone echocardiographic viability test: A pilot study", J AM S ECHO, 14(7), 2001, pp. 668-675

Abstract

We assessed the utility of milrinone to predict recovery of function aftersurgical myocardial revascularization In patients with severe baseline left ventricular systolic dysfunction caused by coronary artery disease (CAD). Prediction of viable myocardial segments that will regain function after revascularization may help in the selection of patients who will benefit from coronary artery bypass graft surgery (CABG) as well as aid in the choice of target sites for coronary revascularization. We Investigated 20 consecutive patients with CAD and left ventricular ejection fraction less than or equal to 40% who had evidence of myocardial viability by either thallium scan or dobutamine viability test and were candidates for elective CABG. Left ventricular regional wall. motion and global ejection fraction were assessed by transesophageal echocardiography in the operating room. Measurements were done before and 10 minutes after milrinone infusion, and Immediately after CABG. Left ventricular wall motion score was derived by means of a la-segment model. Functional improvement for each segment was defined as a wallmotion change >1. Baseline ejection fraction was 27% +/- 5% (mean rt SD). Ejection fraction increased to 35% +/- 5% after milrinone infusion (P < .0001) and to 36% +/- 6% after CABG (P < .0001). Post-CABG ejection fraction was significantly correlated with postmilrinone ejection fraction (r = 0.65,P <less than> .0001), Milrinone infusion resulted in augmentation of contraction in 98 of the 209 abnormal segments (wall motion score greater than or equal to2); 91 (92.9%) of these improved after CABG. One hundred nine of the 111 segments that showed no improvement with milrinone did not improve after revascularization (98.2%). Seventy-three segments were akinetic or dyskinetic at baseline; 46 (63.0%) of these improved with milrinone. Improvement in regional wall. motion after revascularization was detected in 84.8% of the segments that improved with milrinone versus only 3.7% of the segments that did not improve with milrinone. In patients with ischemic cardiomyopathy, improvement in left ventricular function (segmental wall motion and global ejection fraction) during milrinone infusion is highly predictive ofimprovement after CABG.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/06/20 alle ore 09:39:38