End-systolic volume and long-term survival after coronary artery bypass graft surgery in patients with impaired left ventricular function.

Hamer, Angus; Takayama, Morimasa; Abraham, K A; Roche, A. F.; Kerr, A.; Williams, Barbara F.; Ramage, M C; White, Harvey D.

doi:10.1161/01.cir.90.6.2899

Cited by 91 publications

(60 citation statements)

References 42 publications

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“…In patients who had a preoperative LVESVI of 100 mL/m 2 or less, we observed a favorable outcome for survival and the recovery of left ventricular function. That finding supports the conclusion of other investigators [23,24] who noted that the LVESVI was the only independent measurement that was predictive of survival and the improvement of left ventricular function. The LVESVI is a simple and noninvasive preoperative predictor of postoperative functional recovery.…”

Section: Predictors Of Late Outcomesupporting

confidence: 91%

Long-Term Results of Coronary Artery Bypass Grafting in Patients With Left Ventricular Dysfunction

Hamad

Tan

Straten

et al. 2008

The Annals of Thoracic Surgery

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Background. In this prospective study, we investigated the determinants of long-term outcome, symptoms, and left ventricular function after coronary artery bypass grafting in patients with a moderate to severely decreased left ventricular ejection fraction.Methods. Between 1997 and 1998, 75 consecutive patients with moderate to severe left ventricular dysfunction underwent coronary artery bypass grafting procedures. The operative mortality rate was 4.0%, and the 72 survivors were monitored for 8 years. The end points were mortality, symptomatic status (New York Heart Association [NYHA] functional class), and left ventricular function.Results. The total survival rate after 8 years was 89.3%. During follow-up, 8 patients died. Death was attributed to a cardiac cause in 5 patients and to a noncardiac cause in 3. There was no statistically significant difference between preoperative and late postoperative NYHA functional class, despite a statistically significant im-

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Section: Predictors Of Late Outcomesupporting

confidence: 91%

Long-Term Results of Coronary Artery Bypass Grafting in Patients With Left Ventricular Dysfunction

Hamad

Tan

Straten

et al. 2008

The Annals of Thoracic Surgery

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“…Risk stratification in patients with LV ischemic dysfunction typically includes a combination of clinical, hemodynamic, and angiographic parameters. 17 Recent studies using myocardial metabolic imaging with positron emission tomography (PET) have indicated that assessing myocardial viability also provides useful prognostic information in these patients, [17][18][19][20][21] with an effect additive to that of the usual clinical assessment. 21 Whereas PET is expensive and not widely available, exercise-redistribution-reinjection thallium scintigraphy and dobutamine echocardiography are less expensive and potentially more widely available methods that can also distinguish viable from nonviable myocardium.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Myocardial Ischemia and Viability in Patients With Chronic Left Ventricular Ischemic Dysfunction

Pasquet¹,

Robert²,

D'hondt³

et al. 1999

Circulation

155

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Background-Previous studies showed that thallium scintigraphy and dobutamine echocardiography were accurate, noninvasive ways of predicting contractile recovery after revascularization in patients with left ventricular (LV) dysfunction. However, the prognostic impact of such methods remains uncertain. Methods and Results-We prospectively studied 137 consecutive patients with coronary disease and LV dysfunction who underwent exercise-redistribution-reinjection thallium scintigraphy and dobutamine echocardiography to identify myocardial ischemia and viability. A total of 94 patients subsequently underwent revascularization, and 43 underwent medical treatment. The primary endpoint was cardiac mortality, and mean follow-up was 33Ϯ10 months. Twenty-four patients died of cardiac causes. By Cox's regression analysis, long-term survival was related to the extent of coronary disease, the presence of diabetes, type of treatment, the presence of ischemic myocardium as determined by thallium scintigraphy, and the presence of viable myocardium as determined by both tests. Three-year survival was greater in patients with ischemic myocardium (as determined by thallium scintigraphy) or viable myocardium (as determined by both tests) who underwent revascularization than in the other groups (Pϭ0.018 with thallium; PϽ0.001 with dobutamine). Subgroup analyses indicated that among patients with 1-or 2-vessel disease, only those with ischemic or viable myocardium improved survival after revascularization, whereas in patients with 3-vessel or left main diseases, revascularization always improved survival, albeit more in the presence of ischemic or viable myocardium. Conclusions-Among the parameters commonly available in patients with LV ischemic dysfunction, the presence of ischemic myocardium (as determined by thallium scintigraphy) and that of viable myocardium (as determined by dobutamine echocardiography) are independent predictors of subsequent mortality. These observations may be useful in the preoperative selection of patients for revascularization. (Circulation. 1999;100:141-148.)

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“…In addition, many other studies, including the present one, demonstrate improved LVEF, functional status, and quality of life, as well as decreased ventricular size, even in long-term follow-up, for patients treated with CABG, which implies reverse remodeling of the failing heart. 9,13,[16][17][18] …”

Section: Discussionmentioning

confidence: 99%

Clinical Results of Coronary Revascularization in Left Ventricular Dysfunction

Lee

Chang

Yoo

et al. 2007

Circ J

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DefinitionsThe number of diseased vessels was defined as the number of the 3 major coronary perfusion territories affected. Perioperative insertion of an intra-aortic balloon pump (IABP) was defined as a procedure for improving hemodynamics in the presence of cardiogenic shock. Postoperative cerebrovascular accident (CVA) was defined as a focal or global neurological deficit confirmed by a neurologist.

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End-systolic volume and long-term survival after coronary artery bypass graft surgery in patients with impaired left ventricular function.

Cited by 91 publications

References 42 publications

Long-Term Results of Coronary Artery Bypass Grafting in Patients With Left Ventricular Dysfunction

Long-Term Results of Coronary Artery Bypass Grafting in Patients With Left Ventricular Dysfunction

Prognostic Value of Myocardial Ischemia and Viability in Patients With Chronic Left Ventricular Ischemic Dysfunction

Clinical Results of Coronary Revascularization in Left Ventricular Dysfunction

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