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Chronic non-transmural infarction has a delayed recovery of function following revascularization

Ugander, Martin LU ; Cain, Peter LU ; Johnsson, Per; Palmer, John LU and Arheden, Håkan LU (2010) In BMC Cardiovascular Disorders 10.
Abstract
Background: The time course of regional functional recovery following revascularization with regards to the presence or absence of infarction is poorly known. We studied the effect of the presence of chronic nontransmural infarction on the time course of recovery of myocardial perfusion and function after elective revascularization. Methods: Eighteen patients (mean age 69, range 52-84, 17 men) prospectively underwent cine magnetic resonance imaging (MRI), delayed contrast enhanced MRI and rest/stress 99m-Tc-tetrofosmin single photon emission computed tomography (SPECT) before, one and six months after elective coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). Results: Dysfunctional myocardial segments (n =... (More)
Background: The time course of regional functional recovery following revascularization with regards to the presence or absence of infarction is poorly known. We studied the effect of the presence of chronic nontransmural infarction on the time course of recovery of myocardial perfusion and function after elective revascularization. Methods: Eighteen patients (mean age 69, range 52-84, 17 men) prospectively underwent cine magnetic resonance imaging (MRI), delayed contrast enhanced MRI and rest/stress 99m-Tc-tetrofosmin single photon emission computed tomography (SPECT) before, one and six months after elective coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). Results: Dysfunctional myocardial segments (n = 337/864, 39%) were classified according to the presence (n = 164) or absence (n = 173) of infarction. Infarct transmurality in dysfunctional segments was largely non-transmural (transmurality = 31 +/- 22%). Quantitative stress perfusion and wall thickening increased at one month in dysfunctional segments without infarction (p < 0.001), with no further improvement at six months. Despite improvements in stress perfusion at one month (p < 0.001), non-transmural infarction displayed a slower and lesser improvement in wall thickening at one (p < 0.05) and six months (p < 0.001). Conclusions: Dysfunctional segments without infarction represent repetitively stunned or hibernating myocardium, and these segments improved both perfusion and function within one month after revascularization with no improvement thereafter. Although dysfunctional segments with non-transmural infarction improved in perfusion at one month, functional recovery was mostly seen between one and six months, possibly reflecting a more severe ischemic burden. These findings may be of value in the clinical assessment of regional functional recovery in the time period after revascularization. (Less)
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organization
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Contribution to journal
publication status
published
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in
BMC Cardiovascular Disorders
volume
10
publisher
BioMed Central
external identifiers
  • wos:000274598400001
  • scopus:76949085741
ISSN
1471-2261
DOI
10.1186/1471-2261-10-4
language
English
LU publication?
yes
id
39dfbec1-1fa0-4727-874f-d4d1618e7d77 (old id 1568678)
date added to LUP
2010-03-17 13:45:43
date last changed
2018-05-29 11:35:51
@article{39dfbec1-1fa0-4727-874f-d4d1618e7d77,
  abstract     = {Background: The time course of regional functional recovery following revascularization with regards to the presence or absence of infarction is poorly known. We studied the effect of the presence of chronic nontransmural infarction on the time course of recovery of myocardial perfusion and function after elective revascularization. Methods: Eighteen patients (mean age 69, range 52-84, 17 men) prospectively underwent cine magnetic resonance imaging (MRI), delayed contrast enhanced MRI and rest/stress 99m-Tc-tetrofosmin single photon emission computed tomography (SPECT) before, one and six months after elective coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). Results: Dysfunctional myocardial segments (n = 337/864, 39%) were classified according to the presence (n = 164) or absence (n = 173) of infarction. Infarct transmurality in dysfunctional segments was largely non-transmural (transmurality = 31 +/- 22%). Quantitative stress perfusion and wall thickening increased at one month in dysfunctional segments without infarction (p &lt; 0.001), with no further improvement at six months. Despite improvements in stress perfusion at one month (p &lt; 0.001), non-transmural infarction displayed a slower and lesser improvement in wall thickening at one (p &lt; 0.05) and six months (p &lt; 0.001). Conclusions: Dysfunctional segments without infarction represent repetitively stunned or hibernating myocardium, and these segments improved both perfusion and function within one month after revascularization with no improvement thereafter. Although dysfunctional segments with non-transmural infarction improved in perfusion at one month, functional recovery was mostly seen between one and six months, possibly reflecting a more severe ischemic burden. These findings may be of value in the clinical assessment of regional functional recovery in the time period after revascularization.},
  author       = {Ugander, Martin and Cain, Peter and Johnsson, Per and Palmer, John and Arheden, Håkan},
  issn         = {1471-2261},
  language     = {eng},
  publisher    = {BioMed Central},
  series       = {BMC Cardiovascular Disorders},
  title        = {Chronic non-transmural infarction has a delayed recovery of function following revascularization},
  url          = {http://dx.doi.org/10.1186/1471-2261-10-4},
  volume       = {10},
  year         = {2010},
}