Related Experiment Video

Updated: Aug 17, 2026

Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats
06:32

Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats

Published on: June 28, 2019

Prognostic implications of myocardial contractile reserve in patients with coronary artery disease and left

F A Chaudhry1, J T Tauke, R S Alessandrini

  • 1Division of Cardiology and the Feinberg Cardiovascular Research Institute, Northwestern University Medical School, Chicago, Illinois, USA.

Journal of the American College of Cardiology
|September 14, 1999
PubMed

Insights

Myocardial contractile reserve (MCR) predicts survival in coronary artery disease (CAD) patients with left ventricular (LV) dysfunction. Revascularization significantly improves survival in patients with substantial MCR, unlike medical therapy alone.

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiac Physiology

Background:

  • Myocardial contractile reserve (MCR) assessed by dobutamine stress echocardiography (DSE) indicates viable myocardium.
  • The impact of revascularization on prognosis for patients with MCR remains unclear.

Purpose of the Study:

  • To evaluate the prognostic significance of MCR in patients with coronary artery disease (CAD) and left ventricular (LV) dysfunction.

Main Methods:

  • Dobutamine stress echocardiography (DSE) was performed on 80 patients with CAD and LV dysfunction (ejection fraction ≤40%).
  • Myocardial viability was identified by enhanced contraction in dysfunctional segments during low-dose dobutamine infusion.
  • Prospective follow-up was conducted for an average of 2.2 years.

Main Results:

  • The number of dysfunctional segments with MCR was the strongest predictor of survival in medically treated patients (p < 0.03).
  • Patients with MCR showed an initial survival advantage with medical therapy, which diminished after three years.
  • Revascularization in patients with MCR (≥5 segments) resulted in excellent three-year survival (93%), compared to medically treated patients (49%, p < 0.02).

Conclusions:

  • MCR is a significant predictor of survival in CAD patients with LV dysfunction on medical therapy.
  • While MCR offers an initial survival benefit, this advantage wanes over three years.
  • Revascularization significantly enhances survival in patients with substantial MCR.
Abstract

More Related Videos

Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in G&#246;ttingen Minipigs and Landrace Pigs14:35

Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs

Published on: April 17, 2021

Dynamic Assessments of Coronary Flow Reserve after Myocardial Ischemia Reperfusion in Mice05:07

Dynamic Assessments of Coronary Flow Reserve after Myocardial Ischemia Reperfusion in Mice

Published on: August 25, 2023

Related Concept Videos

Pathophysiology of Cardiac Performance01:29

Pathophysiology of Cardiac Performance

Typical heart performance is influenced by heart rate, rhythm, myocardial contraction, and metabolism or blood flow. The cardiac muscle exhibits distinct electrophysiological features, including pacemaker activity and calcium channel control, which play a vital role in the heart's response to various drugs. The autonomic nervous system, comprising the sympathetic and parasympathetic branches, regulates heart rate. Sympathetic activation increases heart rate, while parasympathetic activation...
Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...