Abstract
Backgrounds: In medically treated patients with ischemic cardiomyopathy, myocardial viability is associated with a worse prognosis than scar. Hibernating myocardium (chronic regional dysfunction with reduced resting flow) assessed with nuclear imaging is a major risk factor for cardiac death when left ventricular function is depressed. End-diastolic wall thickness (EDWT) is an important and easy marker of myocardial viability in patients with suspected hibernation, as well as Tl-201 scintigraphy. Thus, in this study, we assessed whether hibernating myocardium evaluated by echocardiography could identify patients with ischemic cardiomyopathy who are at high risk for sudden cardiac death (SCD) and mortality. Methods: Patients with ischemic cardiomyopathy who showed low-grade cardiac function (ejection fraction (EF) < or =50%) and had no plans for coronary revascularization were enrolled. All patients underwent coronary angiography and echocardiography. Hibernating myocardium was defined as the area with major epicardial artery stenosis > or =75%, wall motion abnormality, and EDWT >6mm. The onset of SCD or mortality was determined by outpatient or telephone follow-up. Results: The study patients consisted of 60 consecutive patients (47 men, EF: 35 ± 8%, follow-up duration: 38 ± 16 months). Results were shown in a figure . Hibernating myocardium significantly increased the risk of SCD and mortality. Conclusion: Hibernating myocardium evaluated by echocardiography can predict SCD and mortality in medically treated patients with ischemic cardiomyopathy. Figure Kalpan-Meler Estimates of the Time to SCD or Mortality
Published Version
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