Benefits of coronary revascularisation in diabetic and non-diabetic patients with ischaemic cardiomyopathy: Role of myocardial viability

Vittoria Rizzello, Don Poldermans, Elena Biagini, Arend F L Schinkel, Eric Boersma, Abdou Elhendy, Fabiola B. Sozzi, Alexander Maat, Jos R T C Roelandt, Jeroen J. Bax

Research output: Contribution to journalArticle

Abstract

Background: Diabetes mellitus in patients with coronary artery disease is associated with poor outcome. In this study, the relation between myocardial viability, diabetes, coronary revascularisation and outcome was evaluated. Methods: 129 patients (31 diabetic, 98 non-diabetic) with ischaemic cardiomyopathy underwent dobutamine stress echocardiography to assess myocardial viability. Patients with ≥ 4 viable segments were defined as viable and patients with <4 viable segments as nonviable. Left ventricular ejection fraction (LVEF) was assessed before and 9-12 months post-revascularisation. At the same time-points, LV volumes were measured to evaluate LV remodelling. Finally, cardiac events were noted during 5-year follow-up. Results: The extent of viable myocardium was comparable between diabetic and non-diabetic patients. After revascularisation, LVEF increased ≥ 5% in 44% of diabetic and in 40% of non-diabetic patients. LVEF only improved in patients with viable myocardium. Ongoing LV remodelling occurred in 36% and 35% of diabetic and non-diabetic patients respectively, and was related to non-viability, whereas viability protected against ongoing LV remodelling, both in diabetic and non-diabetic patients. Viability was the only predictor of survival after revascularisation. Conclusions: Diabetic, viable patients with ischaemic LV dysfunction exhibit improvement in LVEF post-revascularisation with prevention of ongoing LV remodelling, similar to non-diabetic patients. Myocardial viability was also the only predictor of long-term outcome.

Original languageEnglish
Pages (from-to)314-320
Number of pages7
JournalEuropean Journal of Heart Failure
Volume8
Issue number3
DOIs
Publication statusPublished - May 2006

Keywords

  • Coronary artery disease
  • Coronary revascularisation
  • Diabetes mellitus
  • Ischaemic cardiomyopathy
  • Myocardial viability

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Benefits of coronary revascularisation in diabetic and non-diabetic patients with ischaemic cardiomyopathy: Role of myocardial viability'. Together they form a unique fingerprint.

  • Cite this

    Rizzello, V., Poldermans, D., Biagini, E., Schinkel, A. F. L., Boersma, E., Elhendy, A., Sozzi, F. B., Maat, A., Roelandt, J. R. T. C., & Bax, J. J. (2006). Benefits of coronary revascularisation in diabetic and non-diabetic patients with ischaemic cardiomyopathy: Role of myocardial viability. European Journal of Heart Failure, 8(3), 314-320. https://doi.org/10.1016/j.ejheart.2005.07.014