Myocardial segments with 76-100% hyperenhancement were 86 times less likely to show functional improvement after revascularization compared to segments without hyperenhancement (P<0.001).
Observational (n=35)
Does the baseline extent of myocardial fibrosis predict the likelihood and time course of functional recovery after revascularization in patients with chronic ischaemic LV dysfunction?
In patients with chronic ischemic LV dysfunction, the likelihood and time course of functional recovery after revascularization are inversely related to the baseline extent of myocardial scar assessed by contrast-enhanced CMR.
p-value: p=<0.001
AIMS: We sought to evaluate the relation between long-term functional outcome after revascularization in patients with chronic ischaemic left ventricular (LV) dysfunction and baseline extent of myocardial fibrosis. METHODS AND RESULTS: Thirty-five patients underwent cine and delayed contrast-enhanced cardiovascular magnetic resonance (deCMR) for the quantitative assessment of regional and global LV functions and segmental extent of hyperenhancement (SEH). Function was assessed 1 month before and 3, 6, and 24 +/- 12 months after revascularization, and temporal changes were related to baseline extent of hyperenhancement. The likelihood of functional improvement was inversely related to the SEH during the entire follow-up: at the end of the study period, segments with 1-25, 26-50, 51-75, and 76-100% SEH were 2, 5, 11, and 86 times, respectively, less likely to have functional improvement than segments without hyperenhancement (multilevel analysis, P < 0.001). Although improvement continued over the whole study period in all SEH groups, the time course was significantly more delayed in segments with more extensive hyperenhancement at baseline (multilevel analysis, P < 0.001). CONCLUSION: In patients with chronic ischaemic LV dysfunction, improvement of dysfunctional but viable myocardium can be considerably delayed. Both the likelihood and the time course of long-term functional improvement are related to the baseline amount of scar, as visualized by deCMR.
Бондаренко et al. (Fri,) conducted a observational in chronic ischaemic left ventricular (LV) dysfunction (n=35). Revascularization vs. Segments without hyperenhancement was evaluated on Functional improvement (p=<0.001). Myocardial segments with 76-100% hyperenhancement were 86 times less likely to show functional improvement after revascularization compared to segments without hyperenhancement (P<0.001).