Relationship between myocardial viability and coronary run-off in jeopardized myocardium.

Abstract

OBJECTIVE:

The aim of this study was to evaluate the relationship between coronary run-off and myocardial viability in jeopardized regions.

METHOD:

We studied 50 patients (40 male, mean age: 55.63 +/- 10.54 years) with coronary artery stenosis >70% and ejection fraction <40% referred for viability study via dobutamine stress echocardiography. The relationship between coronary run-off and viability was evaluated. Good run-off demonstrates good or moderate and no run-off means poor or no run-off.

RESULTS:

In the apical region, 33% of the segments with good antegrade run-off were viable and 67% nonviable. Also, 72% of the segments with no run-off were nonviable and 28% viable. In the midportion region, 70% of the segments with good antegrade run-off were viable and 30% nonviable; 50% of the segments with no run-off were nonviable and 50% viable. In the basal region, 85% of the segments with good antegrade run-off were viable and 15% nonviable; 19% of the segments with no run-off were nonviable and 81% viable. The proportion of the nonviable segments increased significantly from the basal to apical regions either with good (p < 0.001) or no run-off (p = 0.004). From 239 viable segments, 58.6% had antegrade, 15.4% retrograde, and 25.5% no run-off. Of 181 nonviable segments, 44% had antegrade, 34% retrograde, and 34.8% no run-off.

CONCLUSION:

There was more susceptibility to nonviability in the apical regions despite good run-off, while the basal segments showed more viability in spite of having no run-off. The findings may be helpful for selecting patients with coronary artery disease and left ventricular systolic dysfunction that benefit from revascularization.

• Authors: Hakimeh Sadeghian, Ebrahim Nematipour, Masoumeh Lotfi-Tokaldany, Mahmood Sheikhfathollahi, Saeed Sadeghian, Sirous Darabian, Seyed Hesameddin Abbasi, Sirous Jahangiri
• Journal: Journal of cardiac surgery (J Card Surg) 2009 Sep-Oct Vol. 24 Issue 5 Pg. 490-4 ISSN: 1540-8191 [Electronic] United States
• PMID: 19549040 (Publication Type: Journal Article)

Topics

• Adult
• Coronary Stenosis (diagnostic imaging, pathology)
• Coronary Vessels (diagnostic imaging, pathology)
• Echocardiography, Stress
• Female
• Humans
• Male
• Middle Aged
• Myocardium (pathology)
• Prospective Studies
• Stroke Volume
• Tissue Survival
• Ventricular Function, Left