SPECTBackground: The extent of scar or viable hypocontractile myocardial tissue determines postinfarction left ventricleremodeling. The aim of this pilot study was to evaluate the revascularization eff ect in a group of patients with ischemiccardiomyopathy and LV systolic dysfunction indicated for surgical revascularization, based on evidence for multivesseldisease on coronarography and viable myocardium (CMR, SPECT).Aims: To evaluate the revascularization eff ect in patients with ischemic LV systolic dysfunction and to fi nd preoperativepredictors of revascularization eff ect.Methods: 33 patients (64±11 years) with baseline LVEF 34.9±9.3 % were included in the study. After a follow-upof 10.7±1.2 months, ECHO and SPECT were performed again. The whole group of patients was divided according torevascularization eff ect (^LVEF > 5 % and ˇLVESV > 5 % compared with baseline) into revascularization responders(R, n = 22) and nonresponders (NR, n = 11).Results: At baseline there was no diff erence between the subgroups in LVEF (R = 35.7±11.0 % vs. NR = 34.3±8.2 %),EDV (R = 183.6±43.2 vs. NR = 180.2±80.5 ml), ESV (R = 118.5±40.4 vs. NR = 119.7±55.2 ml).The responders showed in a revascularization eff ect subanalysis diff erences in the values of LVEF (+9.8±8.1 %,p < 0.009), reduction of EDV (–39.9±50.9 ml, p = 0.05) and ESV (–35.4±42.6 ml, p = 0,002) compared with baseline.The only preoperative parameters predicting LV reverse remodeling were the TE-Em (R = –10.6±44.1 vs. NR =29.7±43.7 ms, p = 0.037) and the size of fi xed perfusion defect (FPD) (R = 11.9±13.5 vs. NR = 22.9±15.3 % of LV,p = 0.044).Conclusions: Patients with ischemic LV systolic dysfunction with a preoperatively determined myocardial viabilitydevelop LV reverse remodeling. The only preoperative parameters predicting LV reverse remodeling were echocardiographicTE-Em and FPD on SPECT.

1 Department of Internal Medicine Teaching Hospital Olomouc

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