Myocardial Viability Detected by Dobutamine Echocardiography in Patients With Chronic Coronary Artery Disease, and Long-Term Outcome After Coronary Angioplasty
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概要
- 論文の詳細を見る
Viable but dysfunctional myocardium detected by dobutamine echocardiography(DE) predicts early improvement in regional left ventricular(LV) function after percutaneous transluminal coronary angioplasty(PTCA). Whether DE can predict the long-term (>2 years) outcome after PTCA is still unclear. Thus, 50 patients (age 60.4±9.5 years) with chronic coronary artery disease and regional LV dysfunction who underwent DE 1 week before PTCA to assess myocardial viability were followed for 4.0±0.8 years. Regional LV function and LV ejection fraction(LVEF) were evaluated by 2-dimensional echocardiography in patients who remained event-free (cardiac death or myocardial infarction or unstable angina pectoris) after PTCA. At late follow-up (>2 years after PTCA), 29 patients showed regional LV function improvement, 15 showed no improvement, 3 showed worsening and 3 patients had cardiac events (1 nonfatal myocardial infarction and 2 unstable angina pectoris). LVEF improved (0.53±0.09 to 0.60±0.09, p<0.001) in patients with improved regional LV function, but deteriorated (0.38±0.03 to 0.30±0.03) in the 3 patients with worsened regional LV function. Of the 29 patients with improvement, 27 (93%) had viable myocardium, whereas only 3 (20%) of the 15 with no improvement had viable myocardium and all 6 of those with poor outcomes (3 with cardiac events and 3 with worsening) had viable myocardium (χ^2=28.9, p<0.001). Patients with viable myocardium and a poor outcome had a lower mean LVEF before PTCA, and at 1 week and 3 months after PTCA (p=0.004, <0.001, and=0.001, respectively), and a higher restenosis rate (p=0.007) than patients with viable myocardium and without a poor outcome. It is concluded that viable myocardium detected by DE may predict long-term improvement in regional and global LV function after PTCA. However, patients with viable myocardium and persistent low LVEF are at risk for cardiac events or worsening of LV function.
- 社団法人日本循環器学会の論文
- 2000-02-20
著者
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Maeda Keiko
The First Department of Internal Medicine, Shiga University of Medical Science
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Kinoshita Masahiko
The First Department of Internal Medicine, Shiga University of Medical Science
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Maeda Keiko
The First Department Of Internal Medicine Shiga University Of Medical Science
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Kinoshita Masahiko
Yabase Central Hospital
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Takahashi Masayuki
The First Department of Internal Medicine, Shiga University of Medical Science
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Kinoshita Masahiko
The First Department Of Internal Medicine Shiga Medical College
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Haque Tuhin
The First Department Of Internal Medicine Shiga University Of Medical Science
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Furukawa Takami
The First Department Of Internal Medicine Shiga University Of Medical Science
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Fukuhara Takehisa
1st Department Of Medicine Shiga University Of Medical Science
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Fukuhara Takehisa
The First Department Of Internal Medicine Shiga University Of Medical Science
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Kinoshita M
First Department Of Internal Medicine Shiga University Of Medical Science
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Kinoshita Masahiko
The 3rd Division Department Of Internal Medicine School Of Medicine Kyoto University
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Kinoshita Masahiko
The First Department Of Internal Medicine
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Takahashi Masayuki
The First Department Of Internal Medicine Shiga University Of Medical Science
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