Long-Term Outcome of a Residual Scar From Myocardial Infarction After Coronary Artery Bypass Grafting : A 100-Month Study Using Myocardial Perfusion Scintigraphy
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概要
- 論文の詳細を見る
The prognosis for patients with a residual scar from myocardial infarction (MI) after coronary artery bypass grafting surgery (CABG) has not been fully evaluated, so the present study retrospectively evaluated such patients with stress myocardial single photon emission computed tomography (SPECT) at 100 months after CABG. The study group consisted of 24 subjects (23 males, 1 female; mean age, 59±9 years) in whom CABG had been performed more than 100 months (mean follow-up period 135±25 months) previously. The 24 subjects were classified into 3 groups according to their summed stress score (SSS) and summed reversibility score (SRS) in the early period after CABG. Eight subjects with MI (SSS≥2 and SRS<2) were classified into the group MI, 8 subjects with ischemic myocardium (SSS≥2 and SRS≥2) was classified into the group RE, and 8 subjects with normal perfusion (SSS<2 and SRS<2) was classified into group N. None of the subjects in group MI required revascularization. Cardiac events occurred in 4 of the group RE patients and all required revascularization. As to the SPECT scoring system, the long-term SSS of group MI (6.4±3.1) was not different from that in the early periods (4.3±4.0; NS). However, the long-term SSS values of group RE (8.8±6.2) were significantly greater than those soon after CABG (3.4±1.8; p=0.03). In group N, there was also no difference in the SSS values between the early period (0.3±0.5) and the long-term period (0.0±0.0; NS). Patients with a residual scar from MI in the early period after CABG did not worsen over a period of 100 months. Moreover, there was no significant difference in the SPECT score in the segment with the residual scar in the short or long term after CABG. However, the extent of reversibility was directly associated with the presence of clinical events. Therefore scintigraphic imaging remains an important and clinically relevant risk stratification tool. Stress myocardial SPECT, early after CABG, can be used to predict the possibility of future cardiac events or the need for revascularization.
- 社団法人日本循環器学会の論文
- 2002-04-20
著者
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Umeda Tatsuya
Third Department of Internal Medicine, Osaka Medical College
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Nakamura Tomomi
The 3rd Division, Department of Internal Medicine
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ADACHI Itaru
Department of Radiology, Osaka Medical College
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Shimomura Hiroaki
Third Division, Department of Internal Medicine, Osaka Medical College
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Kitaura Yasushi
Third Department Of Internal Medicine Osaka Medical College
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Narabayashi Isamu
Department Of Radiology Osaka Medical College
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Adachi I
Department Of Radiology Osaka Medical College
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Adachi Itaru
Department Of Radiology Osaka Medical College
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Umeda Tatsuya
Third Department Of Internal Medicine Osaka Medical College
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Miyazaki Sadae
Third Department Of Internal Medicine Osaka Medical College
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Nakamura Tomomi
The 3rd Division Department Of Internal Medicine
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Akagi Hiroaki
Department of Radiology, Osaka Medical College
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Nakamura Tomomi
Third Department of Internal Medicine, Osaka Medical College
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Shimomura Hiroaki
Third Department Of Internal Medicine Osaka Medical College
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Narabayashi Isamu
Departinent Of Radiologv Osaka Medical College
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Akagi Hiroaki
Department Of Radiology Osaka Medical College
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Umeda Tatsuya
Third Division Department Of Internal Medicine Osaka Medical College
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