Prolonged ischemic heart disease and coronary artery bypass - relation to contractile reserve
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Prolonged ischemic heart disease and coronary artery bypass - relation to contractile reserve. / Kofoed, Klaus F; Bangsgaard, Regitze; Carstensen, Steen; Svendsen, Jesper H; Hansen, Peter R; Arendrup, Henrik; Hesse, Birger; Kelbaek, Henning.
In: European Journal of Cardio-Thoracic Surgery, Vol. 21, No. 3, 2002, p. 417-23.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Prolonged ischemic heart disease and coronary artery bypass - relation to contractile reserve
AU - Kofoed, Klaus F
AU - Bangsgaard, Regitze
AU - Carstensen, Steen
AU - Svendsen, Jesper H
AU - Hansen, Peter R
AU - Arendrup, Henrik
AU - Hesse, Birger
AU - Kelbaek, Henning
N1 - Keywords: Coronary Artery Bypass; Dobutamine; Echocardiography; Female; Heart; Humans; Male; Middle Aged; Myocardial Contraction; Myocardial Ischemia; Tomography, Emission-Computed; Ventricular Dysfunction, Left
PY - 2002
Y1 - 2002
N2 - OBJECTIVE: A major effect of coronary artery bypass grafting (CABG) in patients with ischemic heart disease and impaired left ventricular (LV) contractile function is believed to be an improvement in LV function due to recovery of dysfunctional, but viable myocardium. However, recent studies have indicated a time limit for such a recovery. We therefore investigated the extent of viable myocardium in patients with impaired LV function due to ischemic heart disease after a prolonged strategy of medical treatment and its relation to changes in clinical variables after CABG. METHODS: Forty-five consecutive patients with a mean duration of ischemic heart symptoms of 9 years and LV ejection fraction (EF) <45% referred for CABG were included and LV extent of viable myocardium was measured preoperatively by glucose metabolism--blood flow positron emission tomography imaging and dobutamine stress echocardiography. Symptoms, exercise-capacity and LV function were evaluated before and 7 months after surgery in event-free survivors. RESULTS: LV extent of myocardial viability was <30% in most patients. In event-free survivors, LVEF decreased from 31+/-7 to 26+/-8% 7 months after CABG. The decrease in LVEF was correlated to the LV extent of myocardial metabolism--blood flow reverse mismatch. Most of the patients experienced an improvement in their angina pectoris, heart failure symptoms and exercise capacity after CABG; the overall 3-year survival was 77%. CONCLUSIONS: Patients with chronic ischemic heart disease and impairment of LV function, in whom an initial long-standing conservative treatment has been practiced, benefit from CABG, despite a lack of LV functional reserve.
AB - OBJECTIVE: A major effect of coronary artery bypass grafting (CABG) in patients with ischemic heart disease and impaired left ventricular (LV) contractile function is believed to be an improvement in LV function due to recovery of dysfunctional, but viable myocardium. However, recent studies have indicated a time limit for such a recovery. We therefore investigated the extent of viable myocardium in patients with impaired LV function due to ischemic heart disease after a prolonged strategy of medical treatment and its relation to changes in clinical variables after CABG. METHODS: Forty-five consecutive patients with a mean duration of ischemic heart symptoms of 9 years and LV ejection fraction (EF) <45% referred for CABG were included and LV extent of viable myocardium was measured preoperatively by glucose metabolism--blood flow positron emission tomography imaging and dobutamine stress echocardiography. Symptoms, exercise-capacity and LV function were evaluated before and 7 months after surgery in event-free survivors. RESULTS: LV extent of myocardial viability was <30% in most patients. In event-free survivors, LVEF decreased from 31+/-7 to 26+/-8% 7 months after CABG. The decrease in LVEF was correlated to the LV extent of myocardial metabolism--blood flow reverse mismatch. Most of the patients experienced an improvement in their angina pectoris, heart failure symptoms and exercise capacity after CABG; the overall 3-year survival was 77%. CONCLUSIONS: Patients with chronic ischemic heart disease and impairment of LV function, in whom an initial long-standing conservative treatment has been practiced, benefit from CABG, despite a lack of LV functional reserve.
M3 - Journal article
C2 - 11888757
VL - 21
SP - 417
EP - 423
JO - European Journal of Cardio-thoracic Surgery
JF - European Journal of Cardio-thoracic Surgery
SN - 1010-7940
IS - 3
ER -
ID: 21259055