Long-term prognosis of left ventricular re-remodeling after surgery of ischemic cardiomyopathy: the potential of tomographic radionuclide ventriculography

Aim. To assess the potential of stress tomographic radionuclide ventriculography (T-RVG) in long-term prognosis of left ventricular (LV) re-remodeling after surgery of ischemic cardiomyopathy.Material and methods. Thirty patients with ischemic cardiomyopathy, before surgical treatment, underwent resting T-RVG and with increasing doses of dopamine (5/10/15 pg/kg/min (5 min/dose). All patients underwent two-dimensional echocardiography before surgery, in the short- (7-14 days) and long-term postoperative period. In the long-term postoperative period (476±36 days), the patients were divided into two groups: group 1 (n=19) — patients with ongoing LV remodeling (increase in the LV end-systolic volume (ESV) or decrease <10% relatively short-term postoperative period), group 2 (n=11) — patients with decreased LV ESV >10%.Results. The results revealed significant differences between the groups in the dynamics (Δ) of the LV ejection fraction (EF) (%) (2 (2;8); 11 (5;12), p=0,02), peak ejection rate (%) (32 (14;51); 63 (34;79), p=0,009), LV dyssynchrony (PSDo (3 (0;7); -2 (-9;3), p=0,004); Entropy (%) (2 (-1;6); 0 (-4;2), p=0,01)). Univariate regression showed that ΔLVEF (odds ratio (OR), 0,88; confidence interval (CI), 0,8; 0,97; p=0.008), ΔLVPSD (OR, 1,13; CI, 1,03; 1,25; p=0,005), and coronary stenosis >75% (OR, 4,25; CI, 1,57; 11,48; p=0,001) had a predictive value. According to the ROC-analysis, the sensitivity, specificity, and AUC were 87%, 64% and 0,727 for ΔLVPSD (threshold >-1); 84%, 46% and 0,691 for coronary stenosis >75% >75% (threshold >2); 65%, 82% and 0,674 for ΔLVEF (threshold ≤4), respectively. The logistic model, which included these parameters and the presence of diabetes, showed a significantly greater AUC (0,907, p<0,05) compared with these indicators taken separately.Conclusion. Preoperative values of ΔLVEF and ΔLVPSD obtained with stress T-RVG have prognostic significance in relation to LV long-term re-remodeling.

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Implications of multiple late gadolinium enhancement lesions on the frequency of left ventricular reverse remodeling and prognosis in patients with non‐ischemic cardiomyopathy

Journal of Cardiovascular Magnetic Resonance ◽

10.1186/s12968-021-00734-3 ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

Shingo Ota ◽

Makoto Orii ◽

Tsuyoshi Nishiguchi ◽

Mao Yokoyama ◽

Ryoko Matsushita ◽

...

Keyword(s):

Heart Failure ◽

Late Gadolinium Enhancement ◽

Ischemic Cardiomyopathy ◽

Left Ventricular ◽

Reverse Remodeling ◽

Cardiac Events ◽

Gadolinium Enhancement ◽

Systolic Volume ◽

Linear Pattern ◽

Multiple Lesions

Abstract Background Non-ischemic cardiomyopathy (NICM) is a heterogeneous disease, and its prognosis varies. Although late gadolinium enhancement (LGE)-cardiovascular magnetic resonance (CMR) demonstrates a linear pattern in the mid-wall of the septum or multiple LGE lesions in patients with NICM, the therapeutic response and prognosis of multiple LGE lesions have not been elucidated. This study aimed to investigate the frequency of left ventricular (LV) reverse remodeling (LVRR) and prognosis in patients with NICM who have multiple LGE lesions. Methods This single-center retrospective study included 101 consecutive patients with NICM who were divided into 3 groups according to LGE-CMR results: patients without LGE (no LGE group = 48 patients), patients with a typical mid-wall LGE pattern (n = 29 patients), and patients with multiple LGE lesions (n = 24 patients). LVRR was defined as an increase in LV ejection fraction (LVEF) ≥ 10 % and a final value of LVEF > 35 %, which was accompanied by a decrease in LV end-systolic volume ≥ 15 % at 12-month follow-up using echocardiography. The frequency of composite cardiac events, defined as sudden cardiac death (SCD), aborted SCD (non-fatal ventricular fibrillation, sustained ventricular tachycardia, or adequate implantable cardioverter-defibrillator therapies), and heart failure death or hospitalization for worsening heart failure, were summarized and compared between the groups. Results Among the 3 groups, the frequency of LVRR was significantly lower in the multiple lesions group than in the no LGE and mid-wall groups (no LGE vs. mid-wall vs. multiple lesions: 49 % vs. 52 % vs. 19 %, p = 0.03). There were 24 composite cardiac events among the patients: 2 in patients without LGE (hospitalization for worsening heart failure; 2), 7 in patients of the mid-wall group (SCD; 1, aborted SCD; 1 and hospitalization for worsening heart failure; 5), and 15 in patients of the multiple lesions group (SCD; 1, aborted SCD; 8 and hospitalization for worsening heart failure; 6). The multiple LGE lesions was an independent predictor of composite cardiac events (hazard ratio: 11.40 [95 % confidence intervals: 1.49−92.01], p = 0.020). Conclusions Patients with multiple LGE lesions have a higher risk of cardiac events and poorer LVRR. The LGE pattern may be useful for an improved risk stratification in patients with NICM.

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Prevalence and Long-Term Prognosis of Patients with Complete Bundle Branch Block (Right or Left Bundle Branch) with Normal Left Ventricular Ejection Fraction Referred for Stress Echocardiography

Echocardiography ◽

10.1111/echo.12680 ◽

2014 ◽

Vol 32 (3) ◽

pp. 483-489 ◽

Cited By ~ 12

Author(s):

Azhar A. Supariwala ◽

Jose Ricardo F. Po ◽

Sameh Mohareb ◽

Farhan Aslam ◽

Firas Kaddaha ◽

...

Keyword(s):

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Stress Echocardiography ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Bundle Branch Block ◽

Ventricular Ejection Fraction ◽

Normal Left Ventricular ◽

Long Term Prognosis

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Serum Brain Natriuretic Peptide Concentration 60 Days After Surgery as a Predictor of Long-Term Prognosis in Patients Implanted With a Left Ventricular Assist Device

ASAIO Journal ◽

10.1097/mat.0000000000000403 ◽

2016 ◽

Vol 62 (4) ◽

pp. 396

Keyword(s):

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Left Ventricular Assist Device ◽

Ventricular Assist Device ◽

Left Ventricular ◽

Assist Device ◽

Ventricular Assist ◽

Left Ventricular Assist ◽

Long Term Prognosis

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LEFT VENTRICULAR GLOBAL LONGITUDINAL STRAIN AND LONG-TERM PROGNOSIS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AFTER ACUTE MYOCARDIAL INFARCTION

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(18)32253-8 ◽

2018 ◽

Vol 71 (11) ◽

pp. A1712

Author(s):

Laurien Goedemans ◽

Rachid Abou ◽

Georgette Hoogslag ◽

Nina Marsan ◽

Victoria Delgado ◽

...

Keyword(s):

Myocardial Infarction ◽

Chronic Obstructive Pulmonary Disease ◽

Acute Myocardial Infarction ◽

Longitudinal Strain ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Long Term Prognosis

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EpCAM and microvascular obstruction in patients with STEMI: a cardiac magnetic resonance study

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeab090.052 ◽

2021 ◽

Vol 22 (Supplement_2) ◽

Author(s):

C Rios-Navarro ◽

J Gavara ◽

J Nunez ◽

C Bonanad Lozano ◽

E Revuelta-Lopez ◽

...

Keyword(s):

Cardiac Magnetic Resonance ◽

Magnetic Resonance ◽

Microvascular Obstruction ◽

Systolic Function ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

P Value ◽

Ventricular Ejection Fraction ◽

Systolic Volume

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): This study was funded by “Instituto de Salud Carlos III” and “Fondos Europeos de Desarrollo Regional FEDER” Bachground. Microvascular obstruction (MVO) is negatively associated with cardiac structure and worse prognosis after ST-segment elevation myocardial infarction (STEMI). Epithelial cell adhesion molecule (EpCAM), involved in endothelium adhesion, is an understudied area in the MVO setting. Purpose. We aimed to evaluate whether EpCAM is associated with the appearance of cardiac magnetic resonance (CMR)-derived MVO and long-term systolic function in reperfused STEMI. Methods. We prospectively included 106 patients with a first STEMI treated with primary percutaneous coronary intervention, quantifying serum levels of EpCAM 24 hours post-reperfusion. All patients underwent CMR imaging 1 week and 6 months post-STEMI. The independent correlation of EpCAM with MVO, systolic volume indices, and left ventricular ejection fraction (LVEF) was evaluated. Results. The mean age of the sample was 59 ± 13 years and 76% were male. Patients were dichotomized according to EpCAM median (4.48 pg/mL). At 1-week CMR, lower EpCAM was related to extensive MVO (p-value = 0.02) and greater infarct size (p-value = 0.02). At presentation, only EpCAM values were significantly associated with the presence of MVO in univariate (Odds Ratio [95% confidence interval] (OR [95% CI]): 0.58 [0.38-0.88], p-value = 0.01) and multivariate logistic regression models (OR [95% CI]: 0.54 [0.34-0.85], p-value = 0.007). Although MVO tends to resolve at chronic phases, decreased EpCAM was associated with worse systolic function: depressed LVEF (p-value = 0.009) and higher left ventricular end-systolic volume (p-value = 0.04). Conclusions. EpCAM is associated with occurrence of CMR-derived MVO at acute phases and long-term adverse ventricular remodeling post-STEMI. Future studies are needed to confirm EpCAM as biomarker, and eventually biotarget in STEMI pathophysiology.

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