Predictive power of late gadolinium enhancement for myocardial recovery in chronic ischaemic heart failure: a HEART sub‐study

Autor: Patrick Sparrow, Sven Plein, John P Greenwood, Adam K McDiarmid, Stephen G. Ball, Huan Loh, John G.F. Cleland, Nikolay P. Nikitin
Rok vydání: 2014
Předmět:
Zdroj: ESC Heart Failure. 1:146-153
ISSN: 2055-5822
DOI: 10.1002/ehf2.12019
Popis: Background The amount of myocardial scar measured by late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) imaging predicts regional recovery in wall motion following revascularization. Previous studies have been conducted in patients with a relatively recent myocardial insult and relatively preserved left ventricular (LV) function. In this sub-study of a clinical trial, the predictive value of LGE, and other CMR-derived data, for myocardial recovery in patients with chronic severe ischaemic cardiomyopathy was assessed. Methods Twenty-two patients with severe LV impairment of ischaemic origin were enrolled as a sub-study of a trial that randomly assigned patients to revascularization or not in addition to guideline-indicated pharmacological therapy. Patients underwent a CMR study at baseline and 6 months. Scans were qualitatively and quantitatively assessed for wall motion, rest/stress myocardial perfusion, and LGE. Results The median duration of heart failure was 13 (inter-quartile range 5–21) months. Patients had severe LV dilatation [end-diastolic volume (EDV) 280 ± 77 mL] and reduction in LV ejection fraction (LVEF) (29 ± 10%). The percentage scar burden by LGE was 17 ± 9%. Patient characteristics of those undergoing revascularization (n = 7) or not (n = 14) were similar. Myocardial perfusion reserve index (MPRI) improved following revascularization (MPRI 1.17 vs. 1.57, P
Databáze: OpenAIRE
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