PMID- 28641397
OWN - NLM
STAT- MEDLINE
DCOM- 20180806
LR  - 20180806
IS  - 1873-734X (Electronic)
IS  - 1010-7940 (Linking)
VI  - 53
IP  - 1
DP  - 2018 Jan 1
TI  - Myocardial scar location as detected by cardiac magnetic resonance is associated 
      with the outcome in heart failure patients undergoing surgical ventricular 
      reconstruction.
PG  - 143-149
LID - 10.1093/ejcts/ezx197 [doi]
AB  - OBJECTIVES: Post-infarction myocardial scar causes adverse left ventricular 
      remodelling and negatively affects the prognosis. We sought to investigate 
      whether scar extent and location obtained by cardiac magnetic resonance may 
      affect the reverse remodelling and survival of heart failure patients undergoing 
      surgical ventricular reconstruction. METHODS: From January 2011 to December 2015, 
      151 consecutive patients with previous myocardial infarction and left ventricular 
      remodelling underwent surgical ventricular reconstruction at our Institution, of 
      which 88 (58%) patients had a preoperative protocol-standardized late gadolinium 
      enhancement (LGE)-cardiac magnetic resonance examination during the week before 
      surgery. We excluded 40 patients with devices (26%), 15 patients with irregular 
      heart rhythm (permanent atrial fibrillation, 10% not included in the device 
      group) or mixed contraindications (severe claustrophobia or presence of material 
      magnetic resonance not compatible). Among the 145 survivors, 11 patients received 
      an implantable cardioverter defibrillator after surgery (mostly for persistent 
      low ejection fraction) and were excluded as well, yielding a total of 59 patients 
      (48 men, aged 65 +/- 9 years) who repeated a protocol-standardized LGE-cardiac 
      magnetic resonance examination even 6 months postoperatively and therefore 
      represent the study population. Patients were grouped according to the presence 
      of LGE in the antero-basal left ventricular segments (Group A) or the absence of 
      LGE in the same segments (Group B). The postoperative left ventricular 
      end-systolic volume index was considered the primary end-point. RESULTS: After 
      surgery, left ventricular end-systolic volume index and end-diastolic volume 
      index significantly decreased (P < 0.001, for both), while diastolic sphericity 
      index and ejection fraction significantly increased (P = 0.015 and P < 0.001, 
      respectively). The presence of LGE in the antero-basal left ventricular segments 
      (10 patients, Group A) was the only independent predictor of outcome (P = 0.02) 
      at multivariate analysis, being the postoperative left ventricular end-systolic 
      volume index significantly higher compared to that of patients of Group B (49 
      patients) (78 +/- 26 ml/m2 vs 55 +/- 20 ml/m2, P = 0.003). Furthermore, patients with 
      a postoperative left ventricular end-systolic volume index >60 ml/m2 showed a 
      higher risk of cardiac events (hazard ratio = 3.67, P = 0.02). CONCLUSIONS: In 
      patients undergoing surgical ventricular reconstruction, LGE scar location 
      affects the left ventricular reverse remodelling, which in turn might limit the 
      survival benefit.
CI  - (c) The Author 2017. Published by Oxford University Press on behalf of the European 
      Association for Cardio-Thoracic Surgery. All rights reserved.
FAU - Castelvecchio, Serenella
AU  - Castelvecchio S
AD  - Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, Milan, 
      Italy.
AD  - Department of Cardiac Surgery, IRCCS Policlinico San Donato, Milan, Italy.
FAU - Careri, Giulia
AU  - Careri G
AD  - Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, Milan, 
      Italy.
FAU - Ambrogi, Federico
AU  - Ambrogi F
AD  - Department of Clinical Sciences and Community Health, University of Milan, Italy.
FAU - Camporeale, Antonia
AU  - Camporeale A
AD  - Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, Milan, 
      Italy.
FAU - Menicanti, Lorenzo
AU  - Menicanti L
AD  - Department of Cardiac Surgery, IRCCS Policlinico San Donato, Milan, Italy.
FAU - Secchi, Francesco
AU  - Secchi F
AD  - Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, Milan, 
      Italy.
FAU - Lombardi, Massimo
AU  - Lombardi M
AD  - Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, Milan, 
      Italy.
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
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
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cicatrix/*diagnostic imaging/etiology/physiopathology
MH  - Echocardiography
MH  - Female
MH  - Heart Failure/*complications
MH  - Humans
MH  - *Magnetic Resonance Imaging/methods
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*complications
MH  - Myocardium
MH  - Prospective Studies
MH  - Ventricular Dysfunction, Left/diagnostic imaging/etiology/mortality/*surgery
MH  - *Ventricular Remodeling
OTO - NOTNLM
OT  - Cardiac magnetic resonance
OT  - Ischaemic heart failure
OT  - Scar tissue
OT  - Surgical ventricular reconstruction
EDAT- 2017/06/24 06:00
MHDA- 2018/08/07 06:00
CRDT- 2017/06/24 06:00
PHST- 2017/01/03 00:00 [received]
PHST- 2017/05/17 00:00 [accepted]
PHST- 2017/06/24 06:00 [pubmed]
PHST- 2018/08/07 06:00 [medline]
PHST- 2017/06/24 06:00 [entrez]
AID - 3882685 [pii]
AID - 10.1093/ejcts/ezx197 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2018 Jan 1;53(1):143-149. doi: 10.1093/ejcts/ezx197.