Therapeutic implications of myocardial lactate metabolism in patients considered candidates for emergency myocardial revascularization
| Autor: | Albert N. Brest, Paul Walinsky, Leslie Wiener, Peter R. Duca, Ronald S. Gottlieb, John Y. Templeton, Frances Hanckel, Hratch Kasparian |
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| Rok vydání: | 1978 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Myocardial revascularization Unstable angina business.industry Mortality rate Context (language use) medicine.disease Bypass surgery Internal medicine medicine Cardiology Surgery In patient Myocardial infarction Cardiology and Cardiovascular Medicine business Coronary sinus |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 75:612-620 |
| ISSN: | 0022-5223 |
| DOI: | 10.1016/s0022-5223(19)41250-6 |
| Popis: | Cardiac angiography has had limited success in predicting the potential for salvage of jeopardized ischemic myocardium. In this context, we have examined the effect of coronary sinus pacing on myocardial lactate extraction in order to determine its predictive role. All 159 patients with unstable angina or acute myocardial infarction were found angiographically suited for coronary bypass surgery. In addition, myocardial lactate extraction was assessed prior to, during, and after coronary sinus pacing. Conventional medical treatment was carried out in 72 patients, whereas 87 patients were treated with coronary bypass surgery. Therapy was determined on clinical and angiographic grounds, independent of myocardial lactate extraction. In medically treated unstable angina, patients with a myocardial lactate production (MLP) of greater than 15 percent showed an in-hospital mortality rate of 21.4 percent; no deaths were observed in those with less than 15 percent MLP (p 15 percent MLP versus 0 percent mortality |
| Databáze: | OpenAIRE |
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