PMID- 15724918
OWN - NLM
STAT- MEDLINE
DCOM- 20050901
LR  - 20061115
IS  - 0040-3660 (Print)
IS  - 0040-3660 (Linking)
VI  - 76
IP  - 12
DP  - 2004
TI  - [Assessment of myocardial viability and recovery of the left ventricular function 
      in postmyocardial infarction patients].
PG  - 12-7
AB  - AIM: To evaluate prognostic significance of myocardial viability (MV) depending 
      on treatment policy in postmyocardial infarction (PMI) patients. MATERIAL AND 
      METHODS: The study included 196 patients (172 males, 24 females, age 30-75, mean 
      age 53 +/- 8.6 years). Standard stress dobutamine echocardiography was made 14 
      +/- 6 days (8-21 days) after macrofocal MI. Reperfusion therapy was made in 138 
      (70%) patients. X-ray contrast coronary angiography was performed in all the 
      patients as the criterion of the immediate effect of reperfusion was achievement 
      of residual stenosis of MI-related coronary artery < 50%. Late after MI (18 +/- 7 
      months after MI) a comparative analysis of the left ventricular function was made 
      in three groups of patients depending on the clinical response to the treatment. 
      MV criterion was based on a fall in the index of infarction zone wall movement 
      (IZWM) under low-dose dobutamine stress test reflecting contractile reserve of 
      the infarction zone (CR). Left ventricular function recovery was judged by a 
      decrease in initial IZWM index 18 months later vs the initial IZWM 14 days later. 
      Thus contractile reversibility of the infarction zone (CRIZ) was determined. LV 
      function was also assessed by the index of left ventricular end diastolic volume 
      (LVEDV), by the index of left ventricular end systolic volume (LVESV), left 
      ventricular ejection fraction (LVEF). RESULTS: 18 months after MI, CRIZ was 
      higher in group 1 (after effective reperfusion) and group 3 (after myocardial 
      revascularization) compared to group 2 (medication only): 0.33 +/- 0.01, 0.39 +/- 
      0.02 and 0.23 +/- 0.01, respectively. LVEDV and LVESV in group 1 and 3 diminished 
      while LVEF increased. LVEDV in group 2 remained elevated though EF rose 
      considerably. CONCLUSION: Recovery of LV contractile function depends much on 
      reestablishment of adequate myocardial perfusion by reperfusion therapy or 
      myocardial revascularization. Chronic myocardial hypoperfusion leads to LV 
      remodeling. CRIZ proved a significant prognostic criterion of the IZWM index 18 
      months after MI only in patients given effective reperfusion therapy.
FAU - Vaolutskene, E
AU  - Vaolutskene E
FAU - Ivashkiavichene, L
AU  - Ivashkiavichene L
FAU - Grabauskene, V
AU  - Grabauskene V
FAU - Lautsavichus, A
AU  - Lautsavichus A
LA  - rus
PT  - English Abstract
PT  - Journal Article
TT  - Otsenka zhiznesposobnosti mikarda i opredelenie vosstanovleniia funktsii levogo 
      zheludochka u bol'nykh, perenesshikh infarkt miokarda.
PL  - Russia (Federation)
TA  - Ter Arkh
JT  - Terapevticheskii arkhiv
JID - 2984818R
SB  - IM
MH  - Adult
MH  - Aged
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Contraction/physiology
MH  - Myocardial Infarction/*therapy
MH  - *Myocardial Reperfusion
MH  - Prognosis
MH  - Recovery of Function/*physiology
MH  - Ventricular Function, Left/*physiology
MH  - Ventricular Remodeling/physiology
EDAT- 2005/02/24 09:00
MHDA- 2005/09/02 09:00
CRDT- 2005/02/24 09:00
PHST- 2005/02/24 09:00 [pubmed]
PHST- 2005/09/02 09:00 [medline]
PHST- 2005/02/24 09:00 [entrez]
PST - ppublish
SO  - Ter Arkh. 2004;76(12):12-7.