| Echocardiographic and cardiac single photon emission computed tomography predictors of left ventricle reverse remodeling after surgical revascularization in patients with ischemic cardiomyopathy and left ventricle systolic dysfunction. | |
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MedLine Citation:
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PMID: 18795088 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The extent of scar or viable hypocontractile myocardial tissue determines postinfarction left ventricle remodeling. The aim of this pilot study was to evaluate the revascularization effect in a group of patients with ischemic cardiomyopathy and LV systolic dysfunction indicated for surgical revascularization, based on evidence for multivessel disease on coronarography and viable myocardium (CMR, SPECT). AIMS: To evaluate the revascularization effect in patients with ischemic LV systolic dysfunction and to find preoperative predictors of revascularization effect. METHODS: 33 patients (64+/-11 years) with baseline LVEF 34.9+/-9.3 % were included in the study. After a follow-up of 10.7+/-1.2 months, ECHO and SPECT were performed again. The whole group of patients was divided according to revascularization effect (postoperative increase LVEF > 5 % and postoperative decrease LVESV > 5 % compared with baseline) into revascularization responders (R, n = 22) and nonresponders (NR, n = 11). RESULTS: At baseline there was no difference between the subgroups in LVEF (R = 35.7+/-11.0 % vs. NR = 34.3+/-8.2 %), EDV (R = 183.6+/-43.2 vs. NR = 180.2+/-80.5 ml), ESV (R = 118.5+/-40.4 vs. NR = 119.7+/-55.2 ml). The responders showed in a revascularization effect subanalysis differences in the values of LVEF (+9.8+/-8.1 %, p < 0.009), reduction of EDV (-39.9+/-50.9 ml, p = 0.05) and ESV (-35.4+/-42.6 ml, p = 0,002) compared with baseline. The only preoperative parameters predicting LV reverse remodeling were the T(E-Em) (R = -10.6+/-44.1 vs. NR = 29.7+/-43.7 ms, p = 0.037) and the size of fixed perfusion defect (FPD) (R = 11.9+/-13.5 vs. NR = 22.9+/-15.3 % of LV, p = 0.044). CONCLUSIONS: Patients with ischemic LV systolic dysfunction with a preoperatively determined myocardial viability develop LV reverse remodeling. The only preoperative parameters predicting LV reverse remodeling were echocardiographic T(E-Em) and FPD on SPECT. |
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Authors:
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Martin Hutyra; Tomas Skala; Milan Kaminek; Petr Nemec |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Biomedical papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia Volume: 152 ISSN: 1213-8118 ISO Abbreviation: Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub Publication Date: 2008 Jun |
Date Detail:
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Created Date: 2008-09-16 Completed Date: 2008-12-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101140142 Medline TA: Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub Country: Czech Republic |
Other Details:
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Languages: eng Pagination: 129-37 Citation Subset: IM |
Affiliation:
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1. Department of Internal Medicine, Teaching Hospital Olomouc, Czech Republic. martinhutyra@seznam.cz |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography* Echocardiography* Female Humans Male Middle Aged Myocardial Ischemia / complications, physiopathology, surgery* Myocardial Revascularization Ventricular Dysfunction, Left / complications* Ventricular Remodeling* |
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