Related Experiment Video

Updated: Jan 13, 2026

Reduction in Left Ventricular Wall Stress and Improvement in Function in Failing Hearts using Algisyl-LVR
07:24

Reduction in Left Ventricular Wall Stress and Improvement in Function in Failing Hearts using Algisyl-LVR

Published on: April 8, 2013

24.7K

Revascularization in Ischemic Left Ventricular Dysfunction: A Pathophysiology-Guided, Evidence-Based Approach

Matthew Ryan1, Alexander G Truesdell2, Gavin J Murphy3

  • 1School of Cardiovascular and Metabolic Medicine & Sciences, British Heart Foundation Centre of Excellence, King's College London, London, United Kingdom.

JACC. Cardiovascular Interventions
|October 28, 2025
PubMed

Insights

Ischemic left ventricular dysfunction (iLVD) management is evolving. This review clarifies coronary revascularization benefits for heart failure patients and guides percutaneous coronary intervention (PCI) decisions.

Area of Science:

  • Cardiology
  • Heart Failure Research
  • Interventional Cardiology

Background:

  • Ischemic left ventricular dysfunction (iLVD) is a leading cause of heart failure with reduced ejection fraction.
  • iLVD is linked to higher mortality rates compared to nonischemic cardiomyopathy.
  • Historically, coronary revascularization was standard for iLVD, but recent trials challenge this practice.

Purpose of the Study:

  • To review the pathophysiology of iLVD.
  • To analyze randomized trial evidence regarding coronary revascularization in iLVD.
  • To define patient selection criteria for coronary artery bypass grafting and percutaneous coronary intervention (PCI) in iLVD.

Main Methods:

  • Comprehensive literature review of pathophysiology and clinical trials.
  • Analysis of randomized evidence for coronary revascularization strategies.
  • Development of a practical guide for PCI in iLVD patients.

Main Results:

  • The review synthesizes current understanding of iLVD pathophysiology.
  • Evidence from recent randomized trials is critically examined.
  • Guidelines are provided for selecting iLVD patients who benefit from revascularization.

Conclusions:

  • Coronary revascularization decisions for iLVD require careful patient selection.
  • Percutaneous coronary intervention (PCI) planning and execution are detailed.
  • Shared decision-making and complete revascularization are emphasized, with future mechanical circulatory support trials noted.

Keywords:
coronary artery diseaseheart failurehigh-risk PCIischemic heart diseasemechanical circulatory supportpercutaneous coronary intervention

More Related Videos

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control05:41

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control

Published on: December 16, 2022

4.3K
Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats06:32

Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats

Published on: June 28, 2019

8.4K

Related Concept Videos

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...
331
Ischemic Heart Disease: Overview01:17

Ischemic Heart Disease: Overview

Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
2.8K
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
704
Coronary Artery Disease II: Pathophysiology01:26

Coronary Artery Disease II: Pathophysiology

Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
360
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
347