TY - JOUR
T1 - Severity of remodeling, myocardial viability, and survival in ischemic LV dysfunction after surgical revascularization
AU - Bonow, Robert O.
AU - Castelvecchio, Serenella
AU - Panza, Julio A.
AU - Berman, Daniel S.
AU - Velazquez, Eric J.
AU - Michler, Robert E.
AU - She, Lilin
AU - Holly, Thomas A.
AU - Desvigne-Nickens, Patrice
AU - Kosevic, Dragana
AU - Rajda, Miroslaw
AU - Chrzanowski, Lukasz
AU - Deja, Marek
AU - Lee, Kerry L.
AU - White, Harvey
AU - Oh, Jae K.
AU - Doenst, Torsten
AU - Hill, James A.
AU - Rouleau, Jean L.
AU - Menicanti, Lorenzo
PY - 2015/10/1
Y1 - 2015/10/1
N2 - Objectives This study sought to test the hypothesis that end-systolic volume (ESV), as a marker of severity of left ventricular (LV) remodeling, influences the relationship between myocardial viability and survival in patients with coronary artery disease and LV systolic dysfunction. Background Retrospective studies of ischemic LV dysfunction suggest that the severity of LV remodeling determines whether myocardial viability predicts improved survival with surgical compared with medical therapy, with coronary artery bypass grafting (CABG) only benefitting patients with viable myocardium who have smaller ESV. However, this has not been tested prospectively. Methods Interactions of end-systolic volume index (ESVI), myocardial viability, and treatment with respect to survival were assessed in patients in the prospective randomized STICH (Comparison of Surgical and Medical Treatment for Congestive Heart Failure and Coronary Artery Disease) trial of CABG versus medical therapy who underwent viability assessment (n = 601; age 61 ± 9 years; ejection fraction 2 (hazard ratio [HR]: 0.85; 95% confidence interval [CI]: 0.56 to 1.29) was no different than in patients with viability and ESVI >84 ml/m2 (HR: 0.87; 95% CI: 0.57 to 1.31). Other ESVI thresholds yielded similar results, including ESVI
AB - Objectives This study sought to test the hypothesis that end-systolic volume (ESV), as a marker of severity of left ventricular (LV) remodeling, influences the relationship between myocardial viability and survival in patients with coronary artery disease and LV systolic dysfunction. Background Retrospective studies of ischemic LV dysfunction suggest that the severity of LV remodeling determines whether myocardial viability predicts improved survival with surgical compared with medical therapy, with coronary artery bypass grafting (CABG) only benefitting patients with viable myocardium who have smaller ESV. However, this has not been tested prospectively. Methods Interactions of end-systolic volume index (ESVI), myocardial viability, and treatment with respect to survival were assessed in patients in the prospective randomized STICH (Comparison of Surgical and Medical Treatment for Congestive Heart Failure and Coronary Artery Disease) trial of CABG versus medical therapy who underwent viability assessment (n = 601; age 61 ± 9 years; ejection fraction 2 (hazard ratio [HR]: 0.85; 95% confidence interval [CI]: 0.56 to 1.29) was no different than in patients with viability and ESVI >84 ml/m2 (HR: 0.87; 95% CI: 0.57 to 1.31). Other ESVI thresholds yielded similar results, including ESVI
KW - coronary artery bypass surgery
KW - coronary artery disease
KW - heart failure
KW - myocardial viability
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U2 - 10.1016/j.jcmg.2015.03.013
DO - 10.1016/j.jcmg.2015.03.013
M3 - Article
AN - SCOPUS:84944047422
VL - 8
SP - 1121
EP - 1129
JO - JACC: Cardiovascular Imaging
JF - JACC: Cardiovascular Imaging
SN - 1936-878X
IS - 10
ER -