Abstract：
:The ideal management of stable patients who present late after acute ST-elevation myocardial infarction (STEMI) is still a matter of conjecture. We hypothesized that the extent of improvement in left ventricular function after successful revascularization in this subset was related to the magnitude of viability in the infarct-related artery territory. However, few studies correlate the improvement of left ventricular function with the magnitude of residual viability in patients who undergo percutaneous coronary intervention in this setting. In 68 patients who presented later than 24 hours after a confirmed first STEMI, we performed resting, nitroglycerin-enhanced, technetium-99m sestamibi single-photon emission computed tomography-myocardial perfusion imaging (SPECT-MPI) before percutaneous coronary intervention, and again 6 months afterwards. Patients whose baseline viable myocardium in the infarct-related artery territory was more than 50%, 20% to 50%, and less than 20% were divided into Groups 1, 2, and 3 (mildly, moderately, and severely reduced viability, respectively). At follow-up, there was significant improvement in end-diastolic volume, end-systolic volume, and left ventricular ejection fraction in Groups 1 and 2, but not in Group 3. We conclude that even late revascularization of the infarct-related artery yields significant improvement in left ventricular remodeling. In patients with more than 20% viable myocardium in the infarct-related artery territory, the extent of improvement in left ventricular function depends upon the amount of viable myocardium present. The SPECT-MPI can be used as a guide for choosing patients for revascularization.
journal_name
Tex Heart Inst Jjournal_title
Texas Heart Institute journalauthors
Goel PK,Bhatia T,Kapoor A,Gambhir S,Pradhan PK,Barai S,Tewari S,Garg N,Kumar S,Jain S,Madhusudan P,Murthy Sdoi
10.14503/THIJ-13-3585subject
Has Abstractpub_date
2014-08-01 00:00:00pages
381-8issue
4eissn
0730-2347issn
1526-6702journal_volume
41pub_type
杂志文章abstract：:The efficiency and risks of a method that allows closed-chest decannulation of an intraoperatively inserted cardiac-assist balloon catheter are examined. The technique involves direct insertion of the balloon catheter into the ascending aorta under the protection of an indwelling silastic tourniquet. At the discretion...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1992-01-01 00:00:00
abstract：:We report on a case of premature atherosclerosis in a patient with short stature, dysmorphic features, mild diabetes mellitus, hypertriglyceridemia, Mönckeberg's sclerosis, and the general appearance of premature aging, compatible with the diagnosis of Werner's Syndrome. The patient was referred to us after suffering ...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
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更新日期：1984-03-01 00:00:00
abstract：:Nephrogenic systemic fibrosis is a recently recognized disease entity that is potentially debilitating. The exact pathogenesis of nephrogenic systemic fibrosis is unclear, but the disease has been linked with the use of gadolinium-based contrast agents, predominantly in patients with acute renal failure or end-stage r...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章,评审
doi：
更新日期：2010-01-01 00:00:00
abstract：:Percutaneous coronary intervention in tortuous or calcified vessels poses a substantial challenge for interventional cardiologists. Many techniques have been described to overcome the challenge, including the use of stiffer wires, buddy wires, the anchor balloon technique, and deep seating of the guide catheter. Herei...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
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更新日期：2011-01-01 00:00:00
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journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：10.14503/THIJ-14-4407
更新日期：2016-02-01 00:00:00
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journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1998-01-01 00:00:00
abstract：:The indications for transcatheter aortic valve implantation have been increasing with the development of new-generation valves and delivery systems. Our patient, an 81-year-old man with aortic stenosis, had an existing coronary artery bypass graft and bilateral aortoiliac bypass grafts. We used the transfemoral approa...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
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更新日期：2012-01-01 00:00:00
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journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1986-03-01 00:00:00
abstract：:In this case report, we describe direct percutaneous delivery of a muscular-ventricular-septal-defect occluder device to close a left ventricular pseudoaneurysm. The occluder was positioned and deployed with the aid of concurrent transthoracic ultrasonography, transesophageal echocardiography, and fluoroscopy. In cont...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：10.14503/THIJ-14-4243
更新日期：2015-08-01 00:00:00
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journal_title：Texas Heart Institute journal
pub_type： 杂志文章,评审
doi：
更新日期：1996-01-01 00:00:00
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journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：10.14503/THIJ-14-4126
更新日期：2015-06-01 00:00:00
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journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1994-01-01 00:00:00
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journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2006-01-01 00:00:00
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journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1988-01-01 00:00:00
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journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2013-01-01 00:00:00
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journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2007-01-01 00:00:00
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journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2012-01-01 00:00:00
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journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：10.14503/THIJ-13-3604
更新日期：2014-06-01 00:00:00
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pub_type： 杂志文章
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journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1982-09-01 00:00:00
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journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1987-12-01 00:00:00
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journal_title：Texas Heart Institute journal
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doi：
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doi：
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journal_title：Texas Heart Institute journal
pub_type： 杂志文章
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更新日期：1989-01-01 00:00:00
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journal_title：Texas Heart Institute journal
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更新日期：1995-01-01 00:00:00
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journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
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