Cardiac imaging improves risk stratification in high-risk patients undergoing surgical procedure (Articolo in rivista)

Type
Label
  • Cardiac imaging improves risk stratification in high-risk patients undergoing surgical procedure (Articolo in rivista) (literal)
Anno
  • 2006-01-01T00:00:00+01:00 (literal)
Alternative label
  • Gimelli A.; L'Abbate A.; Glauber M.; Ripoli A.; Giorgetti A.; Marzullo P. (2006)
    Cardiac imaging improves risk stratification in high-risk patients undergoing surgical procedure
    (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#autori
  • Gimelli A.; L'Abbate A.; Glauber M.; Ripoli A.; Giorgetti A.; Marzullo P. (literal)
Pagina inizio
  • 51 (literal)
Pagina fine
  • 56 (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#numeroVolume
  • 7 (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#note
  • In: Journal of Cardiovascular Medicine, vol. 7 (1) pp. 51-56. Lippincott William & Wilins, 2006. (literal)
Titolo
  • Cardiac imaging improves risk stratification in high-risk patients undergoing surgical procedure (literal)
Abstract
  • OBJECTIVE: In patients with ischaemic left ventricular dysfunction, multivessel disease and dominance of necrotic myocardium, perioperative mortality due to coronary artery bypass grafting is still a rather unclear issue. The aim of this study was to analyse the impact of different imaging variables in predicting perioperative mortality. METHODS: We selected a group of 259 patients who had preoperatively been defined as 'high-risk patients' and who showed a mostly necrotic myocardium as detected by thallium-201 myocardial scintigraphy. RESULTS: Mean ejection fraction was 0.26 +/- 0.07. In a 16-segment model, the mean number of scintigraphic necrotic myocardial segments was 5.07 +/- 1.09, echocardiographic end-diastolic diameter was 29.41 +/- 2.38 mm/m2 and wall motion score index was 2.29 +/- 0.19. Perioperative mortality increased along with the increase in the number of necrotic segments: 5/105 (5%), 4/63 (6%), 8/52 (15%) and 8/39 (20%) patients with four, five, six and seven necrotic segments, respectively. The analysis of additional variables in survived vs. deceased patients demonstrated a significant difference in echocardiographic end-diastolic diameter (27 +/- 8 vs. 31.9 +/- 1.9 mm/m2, P 0.001) and in wall motion score index (2.2 +/- 0.1 vs. 2.4 +/- 0.2, P 0.001). CONCLUSIONS: In high-risk patients, the extension of scintigraphic myocardial scar has a significant impact on perioperative mortality. For similar values of ejection fraction at rest, additional imaging variables, such as echocardiographic end-diastolic diameter and wall motion score index, may contribute to select those patients in whom mortality may exceed 15%. (literal)
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