| Resting 12-lead electrocardiogram as a reliable predictor of functional recovery after recanalization of chronic total coronary occlusions. | |
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MedLine Citation:
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PMID: 16028465 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: A major goal of revascularization is the recovery of left ventricular (LV) function. Nuclear imaging techniques are widely used for detecting recovery of function with a good sensitivity, but only moderate specificity. Predictors of recovery in chronic total coronary occlusions (CTO) are not investigated. HYPOTHESIS: The 12-lead-resting electrocardiogram (ECG) is a predictor of LV recovery after successful recanalization of CTO. METHODS: Successful recanalization of CTO was performed in 127 patients. Of these, 62 patients, who constitute the study group, had impaired regional wall motion prior to recanalization. The 12-lead resting ECG was evaluated for Q-wave areas and parameters of QT dispersion. Impairment of regional wall motion was evaluated by LV angiogram at baseline and at follow-up. RESULTS: Angiographic follow-up after 5 +/- 1.4 months documented reocclusion in eight patients. Complete follow-up with a patent coronary artery and an ECG without bundle-branch block was available in 43 patients. Wall motion severity index (WMSI) improved from -2.92 +/- 0.28 to -1.34 +/- 0.61 (p < 0.001) in patients without Q waves, whereas it was unchanged in patients with Q waves (-3.01 +/- 0.30 and -2.81 +/- 0.32). Absence of Q waves at baseline predicted recovery of regional wall motion with 89% sensitivity and 67% specificity. Positive predictive value for recovery was 68% in patients without Q waves, but only 11% in patients with Q waves. In multivariate analysis, only absence of Q waves predicted improvement in WMSI (p = 0.01). CONCLUSIONS: In patients with recanalization of CTO, recovery of regional wall motion is reliably predicted by analysis of the resting 12-lead ECG for pathologic Q waves. |
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Authors:
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Ralf Surber; Gero Schwarz; Hans R Figulla; Gerald S Werner |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Clinical cardiology Volume: 28 ISSN: 0160-9289 ISO Abbreviation: Clin Cardiol Publication Date: 2005 Jun |
Date Detail:
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Created Date: 2005-07-20 Completed Date: 2005-10-13 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7903272 Medline TA: Clin Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 293-7 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine I, Division of Cardiology and Angiology, Friedrich Schiller University, Jena, Germany. ralf.surber@med.uni-jena.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Coronary Angiography Coronary Stenosis / physiopathology*, radiography, surgery Electrocardiography / methods* Female Follow-Up Studies Humans Male Middle Aged Myocardial Contraction / physiology Myocardial Revascularization* Predictive Value of Tests Rest / physiology* Retrospective Studies Treatment Outcome Ventricular Function, Left / physiology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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