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

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Effect of improvement in left ventricular ejection fraction on long-term survival in revascularized patients with

Kruti Joshi1, Irshad Alam, Emily Ruden

  • 1Krannert Institute of Cardiology, Indiana University School of Medicine, 1801 North Senate Blvd., M.P.C. II, Suite D4082, Indianapolis, IN 46202, USA.

European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology
|May 10, 2011
PubMed

Insights

Improving ejection fraction is key for revascularized patients with heart dysfunction. Myocardial viability and digoxin use also independently predict long-term outcomes, adding value to ejection fraction improvement.

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiac Surgery

Background:

  • Ischaemic left ventricular (LV) dysfunction impacts prognosis after revascularization.
  • The prognostic significance of ejection fraction (EF) improvement in these patients remains uncertain.

Purpose of the Study:

  • To determine if EF improvement independently predicts long-term outcomes in patients with ischaemic LV dysfunction post-revascularization.
  • To assess the incremental prognostic value of myocardial viability and digoxin use on outcomes.

Main Methods:

  • Eighty-seven patients with ischaemic LV dysfunction underwent dobutamine echocardiography before revascularization (coronary bypass graft surgery or percutaneous intervention).
  • Echocardiograms were repeated post-revascularization, and patients were followed for cardiac death over a mean of 5.2 years.
  • Statistical analysis identified independent predictors of outcome, including EF improvement, wall motion score, and digoxin use.

Main Results:

  • Ejection fraction improvement was an independent predictor of improved long-term survival (P=0.02, HR=0.26).
  • Low-dose wall motion score (indicating myocardial viability) and digoxin use were also independent predictors of outcome.
  • Both low-dose wall motion score and digoxin use provided incremental prognostic value beyond EF improvement.

Conclusions:

  • Ejection fraction improvement is a significant independent predictor of long-term prognosis in revascularized patients.
  • Myocardial viability assessment (low-dose wall motion score) and post-procedure digoxin use are also independent prognostic factors.
  • These factors offer additional predictive information when considered alongside EF improvement for patient outcomes.
Abstract

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