PMID- 28446548
OWN - NLM
STAT- MEDLINE
DCOM- 20170901
LR  - 20181113
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Print)
IS  - 1355-6037 (Linking)
VI  - 103
IP  - 17
DP  - 2017 Sep
TI  - Regional left ventricular function does not predict survival in ischaemic 
      cardiomyopathy after cardiac surgery.
PG  - 1359-1367
LID - 10.1136/heartjnl-2016-310693 [doi]
AB  - OBJECTIVES: To define the prognostic contribution of global and regional left 
      ventricular (LV) function measurements in patients with ischaemic cardiomyopathy 
      randomised to coronary artery bypass graft surgery (CABG) with (n=501) or without 
      (n=499) surgical ventricular reconstruction (SVR). METHODS: Novel multivariable 
      methods to analyse global and regional LV systolic function were used to better 
      formulate prediction models for long-term mortality following CABG with or 
      without SVR in the entire cohort of 1000 randomised SVR hypothesis patients. Key 
      clinical variables were included in the analysis. Regional function was 
      classified according to the discreteness of anteroapical hypokinesia and akinesia 
      into those most likely to benefit from SVR, those least likely and those felt to 
      have intermediate likelihood of benefit from SVR. RESULTS: The most prognostic 
      clinical variables identified in multivariable models include creatinine, LV 
      end-systolic volume index (ESVI), age and NYHA (New York Heart Association) 
      class. Addition of LV ejection fraction, LV end-diastolic volume index and 
      regional function assessment did not contribute additional power to the model. 
      Subgroup analysis based on regional function did not identify a cohort in which 
      SVR improved mortality. CONCLUSIONS: ESVI is the single parameter of LV function 
      most predictive of mortality in patients with LV systolic dysfunction following 
      CABG with or without SVR in multivariable models that include all key clinical 
      and LV systolic function parameters. Assessment of regional cardiac function does 
      not enhance prediction of mortality nor identify a subgroup for which SVR 
      improves mortality. These results do not support elective addition of LV 
      reconstruction surgery in patients undergoing CABG. TRIAL REGISTRATION NUMBER: 
      NCT00023595.
CI  - (c) Article author(s) (or their employer(s) unless otherwise stated in the text of 
      the article) 2017. All rights reserved. No commercial use is permitted unless 
      otherwise expressly granted.
FAU - Prior, David L
AU  - Prior DL
AD  - Department of Medicine, St. Vincent's Hospital, University of Melbourne, 
      Melbourne, Australia.
FAU - Stevens, Susanna R
AU  - Stevens SR
AD  - Duke Clinical Research Institute (SRS,RHJ,HRA) and Department of Surgery 
      Cardiothoracic (RHJ), Duke University School of Medicine, Durham, North Carolina, 
      USA.
FAU - Holly, Thomas A
AU  - Holly TA
AD  - Department of Medicine-Cardiology, Northwestern University Feinberg School of 
      Medicine, Chicago, Illinois, USA.
FAU - Krejca, Michal
AU  - Krejca M
AD  - 1st Cardiac Surgery Department, Medical University of Silesia, Katowice, Poland.
FAU - Paraforos, Alexandros
AU  - Paraforos A
AD  - Department of Surgery-Cardiac, University of Trier, Trier, Germany.
FAU - Pohost, Gerald M
AU  - Pohost GM
AD  - Department of Medicine-Cardiology, University of Southern California, Los 
      Angeles, California, USA.
FAU - Byrd, Krysti
AU  - Byrd K
AD  - Duke Clinical Research Institute (SRS,RHJ,HRA) and Department of Surgery 
      Cardiothoracic (RHJ), Duke University School of Medicine, Durham, North Carolina, 
      USA.
FAU - Kukulski, Tomasz
AU  - Kukulski T
AD  - Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia, 
      Katowice, Silesian Center for Heart Diseases, Zabrze, Poland.
FAU - Jones, Robert H
AU  - Jones RH
AD  - Duke Clinical Research Institute (SRS,RHJ,HRA) and Department of Surgery 
      Cardiothoracic (RHJ), Duke University School of Medicine, Durham, North Carolina, 
      USA.
FAU - Desvigne-Nickens, Patrice
AU  - Desvigne-Nickens P
AD  - National Heart, Lung and Blood Institute, National Institutes of Health, 
      Bethesda, Maryland, USA.
FAU - Varadarajan, Padmini
AU  - Varadarajan P
AD  - Department of Medicine-Cardiology, Loma Linda University Medical Center, Loma 
      Linda, California, USA.
FAU - Amanullah, Aman
AU  - Amanullah A
AD  - Department of Medicine-Cardiology, Albert Einstein Medical Center, Philadelphia, 
      Pennsylvania, USA.
FAU - Lin, Grace
AU  - Lin G
AD  - Department of Medicine-Cardiology, Mayo Clinic, Rochester, New York, USA.
FAU - Al-Khalidi, Hussein R
AU  - Al-Khalidi HR
AD  - Duke Clinical Research Institute (SRS,RHJ,HRA) and Department of Surgery 
      Cardiothoracic (RHJ), Duke University School of Medicine, Durham, North Carolina, 
      USA.
FAU - Aldea, Gabriel
AU  - Aldea G
AD  - Department of Surgery-Cardiothoracic, University of Washington Medical Center, 
      Seattle, Washington, USA.
FAU - Santambrogio, Carlo
AU  - Santambrogio C
AD  - Department of Medicine-Cardiology, Policlinico San Donato, Milan, Italy.
FAU - Bochenek, Andrzej
AU  - Bochenek A
AD  - 1st Cardiac Surgery Department, Medical University of Silesia, Katowice, Poland.
FAU - Berman, Daniel S
AU  - Berman DS
AD  - Department of Medicine-Nuclear Cardiology, Cedars-Sinai Medical Center, Los 
      Angeles, California, USA.
CN  - STICH Trial Investigators
LA  - eng
SI  - ClinicalTrials.gov/NCT00023595
GR  - R01 HL105853/HL/NHLBI NIH HHS/United States
GR  - U01 HL069013/HL/NHLBI NIH HHS/United States
GR  - U01 HL069015/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
DEP - 20170426
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
CIN - Heart. 2018 Jan;104(2):1. PMID: 29298846
CIN - Heart. 2018 Jan;104(2):1. PMID: 29298847
MH  - Aged
MH  - *Cardiac Surgical Procedures
MH  - Cardiomyopathies/mortality/physiopathology/*surgery
MH  - Echocardiography
MH  - Female
MH  - Heart Ventricles/diagnostic imaging/*physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Ischemia/mortality/physiopathology/*surgery
MH  - Postoperative Period
MH  - Prognosis
MH  - Survival Rate/trends
MH  - United States/epidemiology
MH  - Ventricular Function, Left/*physiology
MH  - *Ventricular Remodeling
PMC - PMC5564397
MID - NIHMS887304
OTO - NOTNLM
OT  - coronary artery bypass grafting
OT  - end-systolic volume index
OT  - ischaemic cardiomyopathy
OT  - randomised clinical trial
OT  - surgical ventricular reconstruction
COIS- Competing interests: DSB participates in royalties to Cedars-Sinai for the 
      software used for some of the SPECT analysis.
EDAT- 2017/04/28 06:00
MHDA- 2017/09/02 06:00
PMCR- 2017/09/01
CRDT- 2017/04/28 06:00
PHST- 2016/09/27 00:00 [received]
PHST- 2017/02/08 00:00 [revised]
PHST- 2017/02/12 00:00 [accepted]
PHST- 2017/04/28 06:00 [pubmed]
PHST- 2017/09/02 06:00 [medline]
PHST- 2017/04/28 06:00 [entrez]
PHST- 2017/09/01 00:00 [pmc-release]
AID - heartjnl-2016-310693 [pii]
AID - 10.1136/heartjnl-2016-310693 [doi]
PST - ppublish
SO  - Heart. 2017 Sep;103(17):1359-1367. doi: 10.1136/heartjnl-2016-310693. Epub 2017 
      Apr 26.