Document Detail


Long-term outcome and the use of revascularization in patients with heart failure, suspected ischemic heart disease, and large reversible myocardial perfusion defects.
MedLine Citation:
PMID:  12040356     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The potential role of coronary revascularization in the management of patients with congestive heart failure and suspected ischemic heart disease remains to be defined. Myocardial perfusion imaging can identify patients with ischemic heart disease as the etiology for left ventricular dysfunction who might benefit from revascularization. METHODS: We retrospectively identified heart failure patients with suspected ischemic heart disease who had large reversible perfusion defects to determine their long-term outcome and rate of revascularization. The study group consisted of 77 patients with congestive heart failure, left ventricular ejection fraction <45%, and suspected ischemic heart disease who underwent myocardial perfusion imaging during the period of January 1, 1991, to December 31, 1997, and had large reversible perfusion defects. RESULTS: The 5-year mortality rate was 57.6%. The revascularization rate was only 13% for 5 years of follow-up. The number of patients undergoing revascularization was too small to assess its impact on outcome. CONCLUSION: These results indicate a high 5-year mortality rate and a low utilization of coronary revascularization in patients with heart failure and large reversible perfusion defects. The low rate of revascularization reflects at least in part the absence of the generalizability of the existing literature to the optimal means of treating patients with heart failure and myocardial ischemia and points to the need for a randomized clinical trial.
Authors:
Wayne L Miller; Susan K Tointon; David O Hodge; Susan M Nelson; Richard J Rodeheffer; Raymond J Gibbons
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  143     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-05-31     Completed Date:  2002-06-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  904-9     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiovascular Diseases and Internal Medicine and the Section of Biostatistics, Mayo Clinic, Rochester, MN 55905, USA. miller.wayne@mayo.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary
Coronary Artery Bypass
Coronary Circulation
Female
Follow-Up Studies
Heart Failure / complications,  mortality,  surgery*
Humans
Male
Myocardial Ischemia / complications,  mortality,  surgery*
Myocardial Revascularization*
Retrospective Studies
Stroke Volume
Treatment Outcome
Ventricular Dysfunction, Left / etiology*,  mortality,  physiopathology

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


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