Rivascolarizzazione del miocardio ibernato

Un problema clinico ancora irrisolto

Translated title of the contribution: Revascularization of hibernating myocardium: A clinical problem still unresolved

Enrico Ammirati, Valentina Guida, Ornella E. Rimoldi, Paolo G. Camici

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

The mid- and long-term outcome of revascularization procedures is still uncertain in patients with chronic left ventricular systolic dysfunction due to coronary artery disease. The identification of dysfunctional myocardial segments with residual viability that can improve after revascularization is pivotal for further patient management. Hibernating myocardium (chronically dysfunctional but still viable tissue) can be identified by positron emission tomography and cardiac magnetic resonance and its presence and extent can predict functional recovery after revascularization. Before beta-blockers were introduced as routine care for heart failure, surgical revascularization appeared to improve survival in these patients. Nowadays, novel medical treatments and devices such as cardiac resynchronization therapy and implantable cardioverter-defibrillators have improved prognosis of these patients and their use is supported by a number of clinical trials. A recently concluded randomized trial, the STICH (Surgical Treatment for Ischemic Heart Failure) trial, has assessed the prognostic benefit derived from revascularization added to optimal medical therapy in patients with ischemic left ventricular dysfunction. This is an overview of the pathophysiological mechanisms as well as the main clinical studies and meta-analyses that have addressed this issue in the past four decades. Furthermore, a brief proposal for a randomized trial to assess effect on prognosis of revascularization of hibernating myocardium will be presented.

Original languageItalian
Pages (from-to)102-109
Number of pages8
JournalGiornale Italiano di Cardiologia
Volume13
Issue number2
DOIs
Publication statusPublished - Feb 2012

Fingerprint

Myocardium
Left Ventricular Dysfunction
Heart Failure
Cardiac Resynchronization Therapy
Implantable Defibrillators
Positron-Emission Tomography
Meta-Analysis
Coronary Artery Disease
Magnetic Resonance Spectroscopy
Therapeutics
Clinical Trials
Equipment and Supplies
Survival

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Rivascolarizzazione del miocardio ibernato : Un problema clinico ancora irrisolto. / Ammirati, Enrico; Guida, Valentina; Rimoldi, Ornella E.; Camici, Paolo G.

In: Giornale Italiano di Cardiologia, Vol. 13, No. 2, 02.2012, p. 102-109.

Research output: Contribution to journalArticle

Ammirati, Enrico ; Guida, Valentina ; Rimoldi, Ornella E. ; Camici, Paolo G. / Rivascolarizzazione del miocardio ibernato : Un problema clinico ancora irrisolto. In: Giornale Italiano di Cardiologia. 2012 ; Vol. 13, No. 2. pp. 102-109.
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