| Title |
Prediction of long-term segmental and global functional recovery of hibernating myocardium after revascularisation based on low dose dobutamine and late gadolinium enhancement cardiovascular magnetic resonance / |
| Authors |
Glaveckaitė, Sigita ; Valevičienė, Nomeda Rima ; Palionis, Darius ; Puronaitė, Roma ; Šerpytis, Pranas ; Laucevičius, Aleksandras |
| DOI |
10.1186/s12968-014-0083-z |
| Full Text |
|
| Is Part of |
Journal of cardiovascular magnetic resonance.. London : BioMed Central Ltd. 2014, Vol. 16, art. no. 83, p. [1-13].. ISSN 1532-429X |
| Keywords [eng] |
Cardiovascular magnetic resonance ; Late gadolinium enhancement ; Contractile reserve ; Revascularisation ; Functional improvement ; Follow-up studies |
| Abstract [eng] |
Background This study sought to evaluate the relation between long-term segmental and global functional outcome after revascularisation in patients with chronic ischaemic left ventricular dysfunction (LVD) and baseline markers of viability: late gadolinium enhancement (LGE) transmurality and contractile reserve (CR). Methods Forty-two patients with chronic ischaemic LVD underwent low-dose dobutamine- (LDD) and late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) before surgical or percutaneous revascularisation. Regional and global left ventricular (LV) functions and LGE were repeatedly assessed 6 ± 1 and 35 ± 6 months after revascularisation. In total, 319 at baseline dysfunctional and successfully revascularised segments were available for statistical analysis. Results The likelihood of long-term functional improvement was directly related to the presence of CR and inversely related to both the LGE and the degree of contractile dysfunction at baseline. The time course of functional improvement was protracted, with significantly more delay in segments with more extensive LGE (p = 0.005) and more severe contractile dysfunction at baseline (p = 0.002). The presence of CR was the predictor of earlier functional improvement (p < 0.0001). Using a definition of viable segment as a segment without any LGE or with any LGE and producing CR during LDD stimulation, ≥55% of viable segments from all dysfunctional and revascularised segments in a patient was the only independent predictor of significant improvement (≥5%) in the left ventricular ejection fraction (LVEF) after revascularisation, with a 72% sensitivity and an 80% specificity (AUC 0.76, p = 0.014). Reverse LV remodelling was observed in patients who had a significant amount of viable myocardium successfully revascularised. |
| Published |
London : BioMed Central Ltd |
| Type |
Journal article |
| Language |
English |
| Publication date |
2014 |
| CC license |
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