PMID- 12204735
OWN - NLM
STAT- MEDLINE
DCOM- 20021203
LR  - 20190513
IS  - 1010-7940 (Print)
IS  - 1010-7940 (Linking)
VI  - 22
IP  - 3
DP  - 2002 Sep
TI  - The beneficial effect of revascularization on jeopardized myocardium: reverse 
      remodeling and improved long-term prognosis.
PG  - 426-30
AB  - OBJECTIVES: To evaluate the impact of viability/ischemia before revascularization 
      on improvement in systolic performance, reverse remodeling, symptoms and 
      long-term prognosis post-revascularization. METHODS: Fifty patients underwent 
      thallium-201 imaging before revascularization to assess stress-induced ischemia 
      and viability ('jeopardized myocardium'). Left ventricular (LV) ejection fraction 
      (EF), LV end-systolic volume index (LVESVI) and LV end-diastolic volume index 
      (LVEDVI) were determined before and 3 months post-revascularization. Graft/vessel 
      patency was controlled by repeat angiography. Long-term follow-up data (New York 
      Heart Association (NYHA) class, hard events) were acquired up to 3 years. 
      RESULTS: Patients with > or = 5 jeopardized segments on thallium-201 imaging 
      demonstrated improvement of LVEF at 3 months (from 35+/-6 to 43+/-6%, P<0.001), 
      with reverse remodeling (LVESVI decreased from 68+/-16 to 52+/-14 ml/m(2), 
      P<0.001; LVEDVI decreased from 103+/-21 to 91+/-18 ml/m(2), P<0.001), and 
      improved in NYHA class with excellent long-term prognosis (0% event rate). 
      Conversely, patients with <5 jeopardized segments failed to improve in LVEF 
      (34+/-4 vs. 33+/-7%, NS), and exhibited ongoing remodeling (LVESVI increased from 
      70+/-14 to 78+/-23 ml/m(2), P<0.001; LVEDVI increased from 106+/-19 to 116+/-25 
      ml/m(2), P<0.001), without improvement in NYHA class, and worse long-term 
      prognosis (29% event rate). CONCLUSION: Patients with jeopardized myocardium 
      benefit from revascularization with improvement in LVEF, reverse remodeling, 
      improvement in NYHA class and favorable long-term prognosis.
FAU - Mule, Jacopo Dalle
AU  - Mule JD
AD  - Unita Operativa di Cardiologia, Ospedale di Pieve di Cadore, ASL 1 Belluno, 
      Italy.
FAU - Bax, Jeroen J
AU  - Bax JJ
FAU - Zingone, Bartolo
AU  - Zingone B
FAU - Martinelli, Felice
AU  - Martinelli F
FAU - Burelli, Claudio
AU  - Burelli C
FAU - Stefania, Anna
AU  - Stefania A
FAU - DiSipio, Liberata
AU  - DiSipio L
FAU - Soravia, Giorgio
AU  - Soravia G
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
RN  - 0 (Thallium Radioisotopes)
SB  - IM
MH  - Aged
MH  - Coronary Angiography
MH  - Coronary Disease/diagnosis/physiopathology/*surgery
MH  - Echocardiography
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Contraction
MH  - *Myocardial Revascularization
MH  - Prognosis
MH  - Stroke Volume
MH  - Thallium Radioisotopes
MH  - Tomography, Emission-Computed, Single-Photon
MH  - Vascular Patency
EDAT- 2002/09/03 10:00
MHDA- 2002/12/04 04:00
CRDT- 2002/09/03 10:00
PHST- 2002/09/03 10:00 [pubmed]
PHST- 2002/12/04 04:00 [medline]
PHST- 2002/09/03 10:00 [entrez]
AID - S1010794002003597 [pii]
AID - 10.1016/s1010-7940(02)00359-7 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2002 Sep;22(3):426-30. doi: 
      10.1016/s1010-7940(02)00359-7.