Coronary revascularisation for postischaemic heart failure : how myocardial viability affects survival
OBJECTIVE: To assess the impact of revascularisation of viable myocardium on survival in patients with postischaemic heart failure.
METHODS: 35 patients (mean (SD) age 58 (7) years) with severe heart failure (New York Heart Association (NYHA) functional class > or = III), mean left ventricular ejection fraction (LVEF) 24 (7)% (range 10-35%), and limited exercise capacity (peak oxygen consumption (VO(2)) 15 (4) ml/kg/min) were studied. 21/35 patients had no angina. Myocardial viability was assessed with quantitative positron emission tomography and the glucose analogue (18)F-fluorodeoxyglucose (FDG) (viable segment = FDG uptake > or = 0.25 micromol/min/g) in all patients before coronary artery bypass grafting. Patients were divided into two groups: group 1, > or = 8 viable dysfunctional segments (mean 12 (2), range 8-15); and group 2, < 8 viable dysfunctional segments (mean 3.5 (3), range 0-7). The two groups were comparable for age, sex, NYHA class, LVEF, and peak VO(2).
RESULTS: Two patients died perioperatively and seven patients died during follow up (mean 33 (14) months). All deaths were from cardiac causes. Kaplan-Meyer survival analysis showed 86% survival for group 1 patients versus 57% for group 2 (p = 0.03). Analysis by Cox proportional hazard model revealed three independent factors for cardiac event free survival: presence of > or = 8 viable segments (p = 0.006); preoperative LVEF (p = 0.002); and patient age (p = 0.01).
CONCLUSION: Revascularisation for postischaemic heart failure can be associated with good survival, which is critically dependent upon the amount of viable myocardium.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
1999 |
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| Erschienen: |
1999 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:82 |
|---|---|
| Enthalten in: |
Heart (British Cardiac Society) - 82(1999), 6 vom: 04. Dez., Seite 684-8 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Pagano, D [VerfasserIn] |
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| Themen: |
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| Anmerkungen: |
Date Completed 23.12.1999 Date Revised 03.05.2019 published: Print Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM105034681 |
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| 100 | 1 | |a Pagano, D |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Coronary revascularisation for postischaemic heart failure |b how myocardial viability affects survival |
| 264 | 1 | |c 1999 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Completed 23.12.1999 | ||
| 500 | |a Date Revised 03.05.2019 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE: To assess the impact of revascularisation of viable myocardium on survival in patients with postischaemic heart failure | ||
| 520 | |a METHODS: 35 patients (mean (SD) age 58 (7) years) with severe heart failure (New York Heart Association (NYHA) functional class > or = III), mean left ventricular ejection fraction (LVEF) 24 (7)% (range 10-35%), and limited exercise capacity (peak oxygen consumption (VO(2)) 15 (4) ml/kg/min) were studied. 21/35 patients had no angina. Myocardial viability was assessed with quantitative positron emission tomography and the glucose analogue (18)F-fluorodeoxyglucose (FDG) (viable segment = FDG uptake > or = 0.25 micromol/min/g) in all patients before coronary artery bypass grafting. Patients were divided into two groups: group 1, > or = 8 viable dysfunctional segments (mean 12 (2), range 8-15); and group 2, < 8 viable dysfunctional segments (mean 3.5 (3), range 0-7). The two groups were comparable for age, sex, NYHA class, LVEF, and peak VO(2) | ||
| 520 | |a RESULTS: Two patients died perioperatively and seven patients died during follow up (mean 33 (14) months). All deaths were from cardiac causes. Kaplan-Meyer survival analysis showed 86% survival for group 1 patients versus 57% for group 2 (p = 0.03). Analysis by Cox proportional hazard model revealed three independent factors for cardiac event free survival: presence of > or = 8 viable segments (p = 0.006); preoperative LVEF (p = 0.002); and patient age (p = 0.01) | ||
| 520 | |a CONCLUSION: Revascularisation for postischaemic heart failure can be associated with good survival, which is critically dependent upon the amount of viable myocardium | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Lewis, M E |e verfasserin |4 aut | |
| 700 | 1 | |a Townend, J N |e verfasserin |4 aut | |
| 700 | 1 | |a Davies, P |e verfasserin |4 aut | |
| 700 | 1 | |a Camici, P G |e verfasserin |4 aut | |
| 700 | 1 | |a Bonser, R S |e verfasserin |4 aut | |
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