What question did this study set out to answer?

February 1, 2001HeartOpen Access

Effects of coronary revascularisation on myocardial blood flow and coronary vasodilator reserve in hibernating myocardium

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Why the study?

Does coronary revascularisation improve myocardial blood flow and coronary vasodilator reserve in hibernating myocardium in patients with multivessel coronary disease?

Population

30 patients with multivessel coronary disease undergoing coronary revascularisation, and 21 age and sex…

Comparison

Coronary revascularisation. vs Before revascularisation and healthy volunteers.

Design

Cohort

Authors

DPDuilio PaganoCardiac Surgery

Discussion

Member takes

Implication

Revascularization was associated with improved vasodilator reserve in hibernating segments; leaves open whether this improves outcomes in multivessel disease.

Key Points

To evaluate resting myocardial blood flow and coronary vasodilator reserve in hibernating myocardium before and after coronary revascularisation.
Assessed 30 patients with multivessel coronary disease undergoing coronary artery bypass grafting (n=21) or angioplasty (n=9) alongside 21 matched healthy controls.
Measured resting and dipyridamole-stimulated myocardial blood flow using oxygen-15 water positron emission tomography and evaluated regional wall motion via echocardiography.
Of 275 dysfunctional segments identified prior to revascularisation, 163 (59%) showed functional recovery following intervention, qualifying as hibernating myocardium.
Resting myocardial blood flow in hibernating segments remained unchanged after revascularisation (0.94 ± 0.3 vs 0.95 ± 0.3 ml/min/g, p = 0.3) and was equivalent to remote segments and controls.
Coronary vasodilator reserve in hibernating segments was severely impaired at baseline compared to controls (p < 0.0001) but significantly increased following revascularisation (1.47 ± 0.7 vs 1.98 ± 1.0, p < 0.0001).

Structured PICO

Does coronary revascularisation improve myocardial blood flow and coronary vasodilator reserve in hibernating myocardium in patients with multivessel coronary disease?

Population

30 patients with multivessel coronary disease undergoing coronary revascularisation (21 patients with bypass grafting and 9 with coronary angioplasty), and 21 age and sex matched healthy volunteers (controls).

Intervention

Coronary revascularisation (bypass grafting or coronary angioplasty).

Comparator

Before revascularisation (within-patient comparison) and healthy volunteers.

Outcome

Myocardial blood flow (MBF) and coronary vasodilator reserve in hibernating myocardium before and after coronary revascularisation, measured by positron emission tomography.surrogate

Coronary revascularization improves impaired coronary vasodilator reserve in hibernating myocardium, despite resting myocardial blood flow remaining unchanged and within normal limits.

Cite This Study

Duilio Pagano (2001) studied this question.

synapsesocial.com/papers/6a8b00dbf8241cb45bfb4550 https://doi.org/10.1136/heart.85.2.208

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Implication

Revascularization was associated with improved vasodilator reserve in hibernating segments; leaves open whether this improves outcomes in multivessel disease.

Effects of coronary revascularisation on myocardial blood flow and coronary vasodilator reserve in hibernating myocardium

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Effects of coronary revascularisation on myocardial blood flow and coronary vasodilator reserve in hibernating myocardium

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider