Document Detail


Assessment of viable myocardium and prediction of postoperative improvement in left ventricular function in patients with severe left ventricular dysfunction by quantitative planar stress-redistribution-reinjection 201-T1 imaging.
MedLine Citation:
PMID:  9049684     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A noninvasive approach to determine viable but asynergic myocardium will be clinically significant in identifying patients with coronary artery disease and severe left ventricular dysfunction who will benefit most from coronary bypass surgery. Accordingly, 12 patients (mean ejection fraction 0.32 +/- 0.03) underwent quantitative planar stress-redistribution-reinjection thallium scintigraphy and radionuclide ventriculography before and 8 weeks after revascularization for viability and segmental and global left ventricular function assessment, respectively. Reinjection scan showed new fill-in in 63% of segments without redistribution. Postoperative improvement in perfusion and function of asynergic segments were significantly better in viable compared to nonviable segments (P < 0.001, P < 0.01, respectively) with a strong correlation between improvement in 201-T1 uptake and function (P < 0.001). When adequacy of revascularization was considered, the predictive value of a positive preoperative viability test for functional improvement was 83%. Finally, mean ejection fraction and global wall motion score increased significantly after revascularization for the group as a whole (0.32 +/- 0.03 to 0.44 +/- 0.04, P < 0.001 and 24.08 +/- 2.90 to 33.16 +/- 3.32, P < 0.001, respectively). Thus, preoperative quantitative planar stress-redistribution-reinjection thallium imaging detects viable but asynergic segments which improve function postoperatively and may be valuable in selection of patients with severe left ventricular dysfunction for revascularization.
Authors:
M Gürsürer; A E Pinarli; M Aksoy; R Tosun; K Yeşilçimen; B Ersek
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of cardiology     Volume:  58     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  1997 Jan 
Date Detail:
Created Date:  1997-05-27     Completed Date:  1997-05-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  179-84     Citation Subset:  IM    
Affiliation:
Prof. Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Chi-Square Distribution
Coronary Artery Bypass / methods*
Evaluation Studies as Topic
Female
Humans
Male
Middle Aged
Predictive Value of Tests
Prognosis
Prospective Studies
Radionuclide Ventriculography / methods,  standards*
Thallium Radioisotopes / diagnostic use
Treatment Outcome
Ventricular Dysfunction, Left / radionuclide imaging*,  surgery*
Chemical
Reg. No./Substance:
0/Thallium Radioisotopes

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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