Document Detail


Myocardial viability detected by dobutamine echocardiography in patients with chronic coronary artery disease, and long-term outcome after coronary angioplasty.
MedLine Citation:
PMID:  10732849     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Viable but dysfunctional myocardium detected by dobutamine echocardiography (DE) predicts early improvement in regional left ventricular (LV) function after percutaneous transluminal coronary angioplasty (PTCA). Whether DE can predict the long-term (>2 years) outcome after PTCA is still unclear. Thus, 50 patients (age 60.4+/-9.5 years) with chronic coronary artery disease and regional LV dysfunction who underwent DE 1 week before PTCA to assess myocardial viability were followed for 4.0+/-0.8 years. Regional LV function and LV ejection fraction (LVEF) were evaluated by 2-dimensional echocardiography in patients who remained event-free (cardiac death or myocardial infarction or unstable angina pectoris) after PTCA. At late follow-up (>2 years after PTCA), 29 patients showed regional LV function improvement, 15 showed no improvement, 3 showed worsening and 3 patients had cardiac events (1 nonfatal myocardial infarction and 2 unstable angina pectoris). LVEF improved (0.53+/-0.09 to 0.60+/-0.09, p<0.001) in patients with improved regional LV function, but deteriorated (0.38+/-0.03 to 0.30+/-0.03) in the 3 patients with worsened regional LV function. Of the 29 patients with improvement, 27 (93%) had viable myocardium, whereas only 3 (20%) of the 15 with no improvement had viable myocardium and all 6 of those with poor outcomes (3 with cardiac events and 3 with worsening) had viable myocardium (chi2 = 28.9, p<0.001). Patients with viable myocardium and a poor outcome had a lower mean LVEF before PTCA, and at 1 week and 3 months after PTCA (p = 0.004, <0.001, and =0.001, respectively), and a higher restenosis rate (p = 0.007) than patients with viable myocardium and without a poor outcome. It is concluded that viable myocardium detected by DE may predict long-term improvement in regional and global LV function after PTCA. However, patients with viable myocardium and persistent low LVEF are at risk for cardiac events or worsening of LV function.
Authors:
T Haque; T Furukawa; M Takahashi; K Maeda; M Kinoshita
Related Documents :
10955369 - Assessment of coagulation and platelet activation in coronary sinus blood induced by tr...
9076549 - Complement activates neutrophils during ptca procedure in patients with unstable angina...
2003519 - Percutaneous transluminal coronary angioplasty in hypothyroidism.
7871179 - Cost-effectiveness analysis in heart disease, part iii: ischemia, congestive heart fail...
1549969 - Stenting of venous bypass grafts: a new treatment modality for patients who are poor ca...
1951119 - Early and late results of coronary angioplasty and bypass in octogenarians.
22772599 - Long-term prognosis after primary pci in unselected patients with st-elevation myocardi...
20015129 - Ddd versus vvir pacing in patients, ages 70 and over, with complete heart block.
23888229 - Surgical treatment concepts for end-stage congenital heart diseases.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Japanese circulation journal     Volume:  64     ISSN:  0047-1828     ISO Abbreviation:  Jpn. Circ. J.     Publication Date:  2000 Mar 
Date Detail:
Created Date:  2000-05-16     Completed Date:  2000-05-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7806868     Medline TA:  Jpn Circ J     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  183-90     Citation Subset:  IM    
Affiliation:
The First Department of Internal Medicine, Shiga University of Medical Science, Japan.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary*
Chronic Disease
Coronary Disease / physiopathology*,  therapy*
Dobutamine
Echocardiography
Female
Heart / physiopathology*
Humans
Male
Middle Aged
Time Factors
Chemical
Reg. No./Substance:
34368-04-2/Dobutamine

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


Previous Document:  Effect of long-term cholesterol-lowering treatment with HMG-CoA reductase inhibitor (simvastatin) on...
Next Document:  Effects of 'cool-down' during exercise recovery on cardiopulmonary systems in patients with coronary...