1,721,051 research outputs found

    Comparison of prognostic value of negative dobutamine stress echocardiography versus single-photon emission computed tomography after acute myocardial infarction

    No full text
    We enrolled 196 patients who had myocardial infarction and no ischemia on dobutamine stress echocardiography (DSE) and/or single-photon emission computed tomography (SPECT). Negative studies were observed in 125 patients on DSE and in 159 on SPECT. Patients were followed for 43 ± 14 months. Cardiac events occurred in 14% of patients who did not have ischemia on DSE and in 9% of patients who did not have ischemia on SPECT. Event-free survival rate was higher in the presence of negative findings on SPECT compared with DSE (p <0.05). The lack of residual myocardial ischemia on SPECT identifies patients at low risk of events, and a negative finding on stress SPECT is superior to a negative finding on DSE

    Survival benefit after revascularization is independent of left ventricular ejection fraction improvement in patients with previous myocardial infarction and viable myocardium

    No full text
    This study was designed to assess the relationships among myocardial viability, changes in left ventricular (LV) ejection fraction after coronary revascularization and long-term event-free survival in patients with previous myocardial infarction and LV dysfunction. We studied 253 patients with previous myocardial infarction and evidence of dysfunctional viable myocardium as assessed by echocardiography and 99mTc-sestamibi imaging. Coronary revascularization was performed in 142 patients, while 111 were medically treated. In revascularized patients, echocardiography was repeated 12 months later to detect LV ejection fraction improvement, defined as an increase of > or =5% compared with baseline. All patients were followed for a mean period of 52+/-29 months. Cardiac death and non-fatal myocardial infarction were considered as events. Event-free survival was higher in revascularized than in medically treated patients (P or =5% in 82 (58%) revascularized patients, and the extent of viable myocardium was the strongest predictor of such improvement (P or =5 viable segments) or low-intermediate (1-4 viable segments) viability (both P<0.01). In conclusion, in patients with previous myocardial infarction and evidence of viable myocardium, coronary revascularization procedures improve outcome at long-term follow-up independently of LV ejection fraction improvement
    corecore