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Long-term prognosis of left ventricular re-remodeling after surgery of ischemic cardiomyopathy: the potential of tomographic radionuclide ventriculography
- Source :
- Российский кардиологический журнал, Vol 25, Iss 11 (2020)
- Publication Year :
- 2020
- Publisher :
- «FIRMA «SILICEA» LLC, 2020.
-
Abstract
- 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%.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, pConclusion. Preoperative values of ΔLVEF and ΔLVPSD obtained with stress T-RVG have prognostic significance in relation to LV long-term re-remodeling.
- Subjects :
- medicine.medical_specialty
Radionuclide ventriculography
030204 cardiovascular system & hematology
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Internal medicine
Diabetes mellitus
Medicine
Diseases of the circulatory (Cardiovascular) system
remodeling
Ejection rate
Ejection fraction
Ischemic cardiomyopathy
business.industry
ischemic cardiomyopathy
Odds ratio
medicine.disease
tomographic radionuclide ventriculography
Confidence interval
Lv dyssynchrony
RC666-701
Cardiology
prognosis
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- Language :
- Russian
- ISSN :
- 26187620 and 15604071
- Volume :
- 25
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- Российский кардиологический журнал
- Accession number :
- edsair.doi.dedup.....b5b7b448106229fed2bd193a35336e65