In patients with ischaemic cardiomyopathy undergoing revascularisation, myocardial viability (contractile reserve in ≥25% of dysfunctional segments) predicted a lower risk of cardiac death (HR 0.34, p=0.02).
Cohort (n=128)
Hazard Ratio: 0.34
valor p: p=0.02
OBJECTIVE: To evaluate the relative merits of viability and ischaemia for prognosis after revascularisation. METHODS: Low-high dose dobutamine stress echocardiography (DSE) was performed before revascularisation in 128 consecutive patients with ischaemic cardiomyopathy (mean (SD) left ventricular ejection fraction (LVEF) 31 (8)%). Viability (defined as contractile reserve (CR)) and ischaemia were assessed during low and high dose dobutamine infusion, respectively. Cardiac death was evaluated during a five year follow up. Clinical, angiographic, and echocardiographic data were analysed to identify predictors of events. RESULTS: Univariable predictors of cardiac death were the presence of multivessel disease (hazard ratio (HR) 0.21, p or = 25% of dysfunctional segments (HR 0.34, p = 0.02). The best multivariable model to predict cardiac death included the presence of multivessel disease, WMSI at low dose DSE, and the presence of CR in > or = 25% of the severely dysfunctional segments (HR 9.62, p < 0.0001). Inclusion of ischaemia in the model did not provide additional predictive value. CONCLUSION: The findings of the present study illustrate that in patients with ischaemic cardiomyopathy, the extent of viability (CR) is a strong predictor of long term prognosis after revascularisation. Ischaemia did not add significantly in predicting outcome.
Rizzello et al. (Wed,) conducted a cohort in Ischaemic cardiomyopathy (n=128). Myocardial viability (contractile reserve in ≥25% of dysfunctional segments) vs. Absence of significant myocardial viability was evaluated on Cardiac death (HR 0.34, p=0.02). In patients with ischaemic cardiomyopathy undergoing revascularisation, myocardial viability (contractile reserve in ≥25% of dysfunctional segments) predicted a lower risk of cardiac death (HR 0.34, p=0.02).