Prognostic value of coronary angiography in patients with chronic ischemic left ventricular dysfunction and evidence of viable myocardium at thallium-201 reinjection imaging
Prognostic value of coronary angiography in patients with chronic ischemic left ventricular dysfunction and evidence of viable myocardium at thallium-201 reinjection imaging(313 views) Cuocolo A, Petretta M, Nicolai E, Pace L, Acampa W, Varrone A, Bonaduce D, Salvatore M
Affiliations: Centro per la Medicina, Nucleare del CNR, Universit Federico II, Via Pansini, 5, 80131 Napoli, Italy
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Norusis, M.J., (1993) SPSS for Windows: Advanced Statistics, Release 6.0., pp. 259-312. , Chicago, Illinois: SPSS Inc
Cox, D.R., Regression models and life table (1972) J R Stat Soc B, 34, pp. 187-220
Kulick, D.L., Rahimtoola, S.H., Risk stratification in survivors of acute myocardial infarction: Routine cardiac catheterization and angiography is a reasonable approach in most patients (1991) Am Heart J, 12, pp. 641-656
Piérard, L.A., De Landsheere, C.M., Berthe, C., Rigo, P., Kulbertus, H.E., Identification of viable myocardium by echocardiography during dobutamine infusion in patients with myocardial infarction after thrombolytic therapy: Comparison with positron emission tomography (1990) J Am Coll Cardiol, 15, pp. 1021-1031
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Ellis, S.E., Alderman, E.L., Cain, K., Wright, A., Bourassa, M., Fisher, L., Morphology of left anterior descending coronary territory lesions as a predictor of anterior myocardial infarction: A CASS registry study (1989) J Am Coll Cardiol, 13, pp. 1481-1491
Prognostic value of coronary angiography in patients with chronic ischemic left ventricular dysfunction and evidence of viable myocardium at thallium-201 reinjection imaging
Background. We evaluated the independent and incremental prognostic value of cardiac catheterization and coronary angiographic data over thallium reinjection after stress redistribution imaging in patients with myocardial infarction and left ventricular dysfunction. Methods and Results. Sixty-nine patients with a first myocardial infarction (> 8 weeks) and left ventricular ejection fraction 40% underwent thallium-201 reinjection after stress redistribution tomographic imaging and cardiac catheterization. During follow-up (mean 26 months) 11 cardiac events (8 cardiac deaths and 3 nonfatal myocardial infarctions) occurred. On Cox regression analysis independent predictors of cardiac events were the sum of reversible and moderately irreversible defects at thallium reinjection (2, 16. 4, p < 0. 005) and the number of reversible defects at stress redistribution (2, 5. 1, P < 0. 05). Moreover, thallium reinjection imaging improved the prognostic power of clinical, exercise, and stress redistribution data (p < 0. 01). The inclusion of left ventricular ejection fraction produced a borderline improvement p = 0. 06), whereas the number of vessels with coronary disease did not. In contrast, in patients at high risk such as those with at least 25% of viable myocardium at reinjection, the number of diseased vessels provided additional prognostic information (p < 0. 05). Conclusions. In patients with chronic ischemic left ventricular dysfunction, left ventricular ejection fraction, but not the number of diseased vessels, provides additional prognostic information to thallium imaging. Therefore coronary angiography seems unnecessary in these patients, unless a significative amount of viable myocardium is detectable
Prognostic value of coronary angiography in patients with chronic ischemic left ventricular dysfunction and evidence of viable myocardium at thallium-201 reinjection imaging
Prognostic value of coronary angiography in patients with chronic ischemic left ventricular dysfunction and evidence of viable myocardium at thallium-201 reinjection imaging
Hesse B, Tagil K, Cuocolo A, Anagnostopoulos C, Bardies M, Bax J, Bengel F, Busemann Sokole E, Davies G, Dondi M, Edenbrandt L, Franken P, Kjaer A, Knuuti J, Lassmann M, Ljungberg M, Marcassa C, Marie PY, Mckiddie F, O'connor M, Prvuolovich E, Underwood R * 3. 0 T perfusion MR imaging(694 views) Rivista Di Neuroradiologia (ISSN: 1120-9976), 2004; 17(6): 807-812. Impact Factor:0.023 ViewExport to BibTeXExport to EndNote