Prediction of long-term reverse left ventricular remodeling after revascularization or medical treatment in patients with ischemic cardiomyopathy: a comparative study between SPECT and MRI
Language English Country United States Media print-electronic
Document type Comparative Study, Journal Article
- MeSH
- Time Factors MeSH
- Ventricular Function, Left * MeSH
- Myocardial Ischemia complications diagnosis physiopathology therapy MeSH
- Tomography, Emission-Computed, Single-Photon * MeSH
- Cardiomyopathies diagnosis etiology physiopathology therapy MeSH
- Cardiovascular Agents therapeutic use MeSH
- Coronary Angiography MeSH
- Coronary Artery Bypass * MeSH
- Middle Aged MeSH
- Humans MeSH
- Magnetic Resonance Imaging * MeSH
- Recovery of Function MeSH
- Predictive Value of Tests MeSH
- Prospective Studies MeSH
- Ventricular Remodeling * MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Stroke Volume MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Comparative Study MeSH
- Geographicals
- Czech Republic MeSH
- Names of Substances
- Cardiovascular Agents MeSH
Patients with ischemic heart disease and depressed left ventricular (LV) ejection fraction (LVEF) develop varying degrees of LV remodeling after cardiac surgical revascularization. Fifty-three patients with stable ischemic heart disease and impaired LV function (LVEF 34.9 ± 4%) were prospectively followed up for 24 months. Thirty-seven patients underwent coronary artery bypass grafting (CABG), 16 patients were treated conservatively. Cardiac magnetic resonance imaging (MRI) and SPECT were performed at baseline and after 12 and 24 months of follow-up. The patients were divided into responders and non-responders depending on the degree of LVEF improvement at 24 months follow-up (>5%-responders). MRI with ≤5 segments with DE/wall thickness ratio (DEWTR) ≥50% predicted LV reverse remodeling with a sensitivity of 86% and a specificity of 75% (AUC 0.81). An MRI finding of ≤2 segments with the DEWTR ≥75% had a corresponding sensitivity of 71% and specificity of 67% (AUC 0.75) while fixed perfusion defect on SPECT <16.5% of LV predicted reverse remodeling with a sensitivity of 64% and a specificity of 69% (AUC 0.64). A preoperative number of segments with the DE/wall thickness ratio of ≥50 and ≥75% obtained by MRI, was found to be a better predictor of left ventricular reverse remodeling than fixed perfusion defect by SPECT. No other MRI or SPECT parameter predicted LVEF improvement at 24 months after CABG.
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Circulation. 1993 May;87(5):1630-41 PubMed
Vnitr Lek. 2008 Apr;54(4):395-401 PubMed
Radiology. 2000 Nov;217(2):572-5 PubMed
J Nucl Med. 2007 Jul;48(7):1096-103 PubMed
Circulation. 2001 Sep 18;104(12 Suppl 1):I314-8 PubMed
N Engl J Med. 2000 Nov 16;343(20):1445-53 PubMed
Circulation. 2005 Dec 13;112(24):3738-44 PubMed
J Thorac Cardiovasc Surg. 2004 Feb;127(2):385-90 PubMed
J Am Coll Cardiol. 2003 Sep 3;42(5):895-901 PubMed
J Cardiovasc Magn Reson. 2007;9(5):815-21 PubMed
Circulation. 2004 Mar 23;109(11):1328-34 PubMed
Am J Cardiol. 2007 Sep 15;100(6):930-6 PubMed
Eur J Nucl Med Mol Imaging. 2007 Jun;34(6):900-9 PubMed
Eur Radiol. 2005 May;15(5):872-80 PubMed
Heart. 2004 Aug;90 Suppl 5:v26-33 PubMed
Am J Cardiol. 2000 Dec 15;86(12):1299-305 PubMed
Radiology. 2003 Jan;226(1):138-44 PubMed
J Am Coll Cardiol. 1999 Jun;33(7):1848-54 PubMed
J Am Coll Cardiol. 2002 Apr 3;39(7):1151-8 PubMed
Ann Saudi Med. 2007 Nov-Dec;27(6):415-20 PubMed
JACC Cardiovasc Imaging. 2009 Jan;2(1):34-44 PubMed
Circulation. 2004 Sep 21;110(12):1535-41 PubMed
Int J Cardiovasc Imaging. 2007 Dec;23(6):757-65 PubMed
J Am Coll Cardiol. 1999 Jul;34(1):163-9 PubMed
J Am Coll Cardiol. 1984 Apr;3(4):902-8 PubMed
Eur Heart J. 2006 Apr;27(7):846-53 PubMed
Circulation. 1983 Oct;68(4):785-95 PubMed
J Nucl Med. 2001 Jan;42(1):79-86 PubMed
Eur Heart J. 2008 Aug;29(16):2000-5 PubMed
J Cardiovasc Magn Reson. 2008 Sep 22;10:41 PubMed
J Nucl Cardiol. 2001 Nov-Dec;8(6):645-51 PubMed
Circulation. 1997 Aug 5;96(3):793-800 PubMed
J Am Coll Cardiol. 2005 Aug 16;46(4):567-74 PubMed
Eur J Nucl Med Mol Imaging. 2005 Jan;32(1):70-4 PubMed
Circulation. 2002 Jan 29;105(4):539-42 PubMed
Am Heart J. 2003 Sep;146(3):535-41 PubMed
Eur J Cardiothorac Surg. 2004 Jul;26(1):89-95 PubMed
Circulation. 2004 Sep 14;110(11 Suppl 1):II18-22 PubMed
JAMA. 1994 Nov 16;272(19):1528-34 PubMed
