Document Detail


Coronary artery bypass grafting with and without concomitant epicardial cardiac resynchronization therapy in patients with ischemic cardiomyopathy: a randomized study.
MedLine Citation:
PMID:  20534420     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Epicardial implantation of a cardiac resynchronization therapy (CRT) system during coronary artery bypass grafting (CABG) may be an additional treatment method for improving left ventricle (LV) systolic function and dyssynchrony in patients with ischemic heart failure.Objective: The objective was to compare the long-term results in patients with severe ischemic heart failure who underwent CABG alone or CABG combined with concomitant epicardial implantation of a CRT system.
METHODS: One hundred sixty-four consecutive patients with severe ischemic heart failure and LV dyssynchrony were enrolled into 2 groups: CABG alone (n = 80) and epicardial CRT implantation during CABG (CABG + CRT) (n = 84). This prospective, randomized, and single-blind study was designed to compare clinical and echocardiography data after 6, 12, and 18 months of follow-up.
RESULTS: In the CABG group, LV systolic function, dyssynchrony signs, and quality of life did not change postoperatively, compared with preoperative data. In contrast, these parameters significantly improved in the CABG + CRT group. The 2 treatment groups did not differ with respect to postoperative improvement in Canadian Cardiovascular Society class (P = .68). The improvement in the New York Heart Association functional class was much more pronounced in the CABG + CRT group than in the CABG group (P = .029). In the CABG group, 21 patients (26.2%) had died by the 18-month follow-up, compared with 9 patients (10.7%) in the CABG + CRT group (P = .012, log-rank test).
CONCLUSION: Epicardial implantation of a CRT system concomitantly with CABG facilitates the early postoperative period, improves LV systolic function, improves the quality of life, and decreases LV dyssynchrony. Moreover, mortality in the CABG + CRT group was significantly lower than in the CABG group.
Authors:
Evgueny Pokushalov; Alexander Romanov; Darya Prohorova; Alexander Cherniavsky; Alexander Karaskov; Borut Gersak
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The heart surgery forum     Volume:  13     ISSN:  1522-6662     ISO Abbreviation:  Heart Surg Forum     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-10     Completed Date:  2011-06-02     Revised Date:  2011-08-05    
Medline Journal Info:
Nlm Unique ID:  100891112     Medline TA:  Heart Surg Forum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E177-84     Citation Subset:  IM    
Affiliation:
State Research Institute of Circulation Pathology, Novosibirsk, Russia. E.Pokushalov@gmail.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Cardiac Pacing, Artificial / methods*
Cardiomyopathies / mortality,  surgery*,  ultrasonography
Coronary Artery Bypass / methods*
Echocardiography, Doppler
Exercise Test
Female
Health Status Indicators
Heart Ventricles*
Humans
Kaplan-Meier Estimate
Logistic Models
Male
Middle Aged
Multivariate Analysis
Myocardial Ischemia / mortality,  surgery*,  ultrasonography
Pericardium*
Questionnaires
Single-Blind Method
Slovenia
Stroke Volume
Systole
Time Factors
Treatment Outcome
Ventricular Function, Left

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


Previous Document:  Ex vivo study of altered mitral apparatus geometry in functional mitral regurgitation.
Next Document:  Importance of erythropoietin in brain protection after cardiac surgery: a pilot study.