Abstract | BACKGROUND: METHODS AND RESULTS: The study population consisted of 135 patients with ischemic heart disease (age, 65+/-9 years; 81% male) and moderate IMR undergoing isolated coronary artery bypass graft surgery. Fourteen patients died before the 12-month follow-up echocardiography and were excluded. At the 12-month follow-up, 57 patients showed no or mild IMR (improvement group), whereas 64 patients failed to improve (failure group). Before coronary artery bypass graft surgery, the improvement group had significantly more viable myocardium and less dyssynchrony between papillary muscles than the failure group (P<0.001). All other preoperative parameters were similar in both groups. Large extent (> or =5 segments) of viable myocardium (odds ratio, 1.45; 95% confidence interval, 1.22 to 1.89; P<0.001) and absence (<60 ms) of dyssynchrony (odds ratio, 1.49; 95% confidence interval, 1.29 to 1.72; P<0.001) were independently associated with improvement in IMR. The majority (93%) of patients with viable myocardium and an absence of dyssynchrony showed an improvement in IMR. In contrast, only 34% and 18% of patients with dyssynchrony and nonviable myocardium, respectively, showed an improvement in IMR, whereas 32% and 49%, respectively, of these patients showed worsening of IMR (P<0.001). CONCLUSIONS: Reliable improvement in moderate IMR by isolated coronary artery bypass graft surgery was observed only in patients with concomitant presence of viable myocardium and absence of dyssynchrony between papillary muscles.
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Authors | Martin Penicka, Hana Linkova, Otto Lang, Richard Fojt, Viktor Kocka, Marc Vanderheyden, Jozef Bartunek |
Journal | Circulation
(Circulation)
Vol. 120
Issue 15
Pg. 1474-81
(Oct 13 2009)
ISSN: 1524-4539 [Electronic] United States |
PMID | 19786637
(Publication Type: Comparative Study, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Topics |
- Aged
- Coronary Artery Bypass
(trends)
- Elective Surgical Procedures
(trends)
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Mitral Valve Insufficiency
(diagnostic imaging, surgery)
- Myocardial Ischemia
(diagnostic imaging, surgery)
- Predictive Value of Tests
- Prospective Studies
- Tomography, Emission-Computed, Single-Photon
(trends)
- Treatment Failure
- Treatment Outcome
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