Anterior Wall Viability and Low Ejection Fraction Predict Functional Improvement After CABG1

Sharma, Sudhish; Raman, Subha V.; Sun, Benjamin; Sai-Sudhakar, Chittoor; Firstenberg, Michael S.; Sirak, John; Crestanello, Juan A.

doi:10.1016/j.jss.2010.03.068

Cited by 4 publications

(1 citation statement)

References 19 publications

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“…It has been demonstrated that contractility after revascularization with PCI or CABG improves in 78% of dysfunctional segments that have no late gadolinium enhancement (LGE), and 60% in those with scar up to 25% of LV wall thickness (4). When analyzed by wall segments, anterior wall viability appears to contribute the most to improvement in left ventricular (LV) function post-CABG (5). It is worth noting that 65-70% of segments with subendocardial infarct that demonstrate severe hypokinesis, dyskinesis or akinesis will have an improvement in contractility after revascularization, stressing the importance of viability testing in patients with pre-operative LV dysfunction to distinguish hibernating myocardium from regions of transmural scar that are not likely to improve with revascularization (4,6).…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Magnetic Resonance

Jiji¹,

Kramer²

2011

Cardiology in Review

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Section: Introductionmentioning

confidence: 99%

Cardiovascular Magnetic Resonance

Jiji¹,

Kramer²

2011

Cardiology in Review

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State of the Art in Cardiomyocyte Transplantation

Hartman

Chong

Laflamme

2017

Cardiac and Vascular Biology

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Effect of Myocardial Viability Assessed by Cardiac Magnetic Resonance on Survival in Patients With Severe Left Ventricular Dysfunction

et al. 2020

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Background: Myocardial viability assessment in revascularization of ischemic heart failure remains controversial. This study evaluated the prognostic utility of cardiac magnetic resonance (CMR) late gadolinium enhancement (LGE) in ischemic heart failure. Methods and Results: This study retrospectively analyzed subjects with ischemic heart failure and left ventricular ejection fraction (LVEF) ≤35%, who underwent CMR at a single center in 2004–2014 before undergoing coronary artery bypass grafting (CABG) or optimal medical therapy (OMT). Analyses were stratified by treatment. Myocardial segments were deemed non-viable if LGE exceeded 50% wall thickness. Overall and anterior viability were assessed. Outcomes were all-cause mortality, cardiovascular (CV) mortality and major adverse CV events. Among 165 subjects (mean (±SD) age 57.5±8.5 years, 152 males), 79 underwent CABG and 86 received OMT. A greater number of non-viable segments was significantly associated with higher all-cause and CV mortality in the CABG group (adjusted hazard ratios 1.17 [95% confidence interval {CI} 1.01–1.37; P=0.04] and 1.25 [95% CI 1.01–1.56; P=0.045], respectively), but not in the OMT (P>0.05) group. Anterior wall viability did not affect outcomes. Conclusions: The extent of myocardial viability assessed by LGE appeared to identify patients with a differential survival benefit from CABG in this retrospective, small cohort study. These findings raise interesting hypotheses that need to be validated in larger prospective studies.

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Anterior Wall Viability and Low Ejection Fraction Predict Functional Improvement After CABG1

Cited by 4 publications

References 19 publications

Cardiovascular Magnetic Resonance

Cardiovascular Magnetic Resonance

State of the Art in Cardiomyocyte Transplantation

Effect of Myocardial Viability Assessed by Cardiac Magnetic Resonance on Survival in Patients With Severe Left Ventricular Dysfunction

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