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Relation of cardiac prognosis to segment location with apical left ventricular ischemia

W Gregory Hundley1, Pairoj Rerkpattanapipat, William C Little

  • 1Department of Internal Medicine (Cardiology Section), Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1045, USA. ghundley@wfubmc.edu

The American Journal of Cardiology
|November 12, 2003
PubMed

Insights

Myocardial ischemia in the left ventricular apex, induced by dobutamine, predicts future cardiac events. This heightened risk applies regardless of the specific location within the apex.

Area of Science:

  • Cardiology
  • Cardiovascular Research
  • Myocardial Infarction Research

Background:

  • Myocardial ischemia in the left ventricular apex has been previously linked to adverse cardiac outcomes.
  • The precise location of ischemia within the apex and its impact on risk stratification required further investigation.

Purpose of the Study:

  • To determine if the heightened risk of future myocardial infarction or cardiac death associated with dobutamine-induced ischemia in the left ventricular apex is dependent on the specific location of the affected distal segment.

Main Methods:

  • Utilizing intravenous dobutamine to induce myocardial ischemia in patients.
  • Analyzing the association between ischemia in distal left ventricular apex segments and subsequent major adverse cardiac events.
  • Assessing whether the location of the ischemic distal segment within the apex modifies this risk.

Main Results:

  • A heightened risk of future myocardial infarction or cardiac death was confirmed in patients with dobutamine-induced ischemia in the left ventricular apex.
  • This increased risk was found to be independent of the precise anatomical location of the distal ischemic segment within the left ventricular apex.

Conclusions:

  • The location of dobutamine-induced ischemia within the left ventricular apex does not alter the associated heightened risk of future cardiac events.
  • Risk stratification for patients experiencing apical ischemia should consider the presence of ischemia, irrespective of its specific apical location.

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