OBJECTIVES The purpose of this stud

OBJECTIVES The purpose of this study was to assess the determinants of mortality in a large group of
patients with ischemic cardiomyopathy who are treated medically and the impact of the extent
of viable tissue on prognosis.
BACKGROUND Whether the presence of viability drives mortality in patients with ischemic cardiomyopathy
who are treated medically and whether the extent of viability is important are issues that are
currently unclear.
METHODS Two hundred sixty-one patients with ischemic cardiomyopathy underwent positron emission
tomography (PET) for assessment of viability. Prospective follow-up was obtained.
RESULTS Ninety-four patients were revascularized and 167 were not. The cardiac death rate was
significantly less in the revascularized patients as compared with medically treated patients
(13% vs. 24%, p
0.05). In the revascularized patients, there was a trend toward better
survival in patients with viable myocardium as compared with nonviable myocardium
(3.5-year survival, 85% and 75% respectively, p  NS). In the medically treated group, age
(hazard ratio [HR] 2.1, 95% confidence interval [CI] 1.2 to 3.7), presence of left bundle
branch block (HR 3.4, 95% CI 1.6 to 7.2) and extent of perfusion-metabolism mismatch on
PET (HR 1.36, 95% CI 1.1 to 1.6) predicted cardiac death during a median follow-up period
of 2.1 years. The risk of cardiac death was not significantly increased when the extent of
mismatch was
20% (HR 0.97, 95% CI 0.46 to 2.05) but was significantly increased when
the extent of mismatch was 20% (HR 3.21, 95% CI 1.38 to 7.49).
CONCLUSIONS Medically treated patients with ischemic cardiomyopathy and large areas of viable myocardium
on PET are at high risk for cardiac death. (J Am Coll Cardiol 2005;46:1264 –9)
© 2005 by the American College of Cardiology Foundation

ผลลัพธ์ (ไทย) 1:

OBJECTIVES The purpose of this study was to assess the determinants of mortality in a large group ofpatients with ischemic cardiomyopathy who are treated medically and the impact of the extentof viable tissue on prognosis.BACKGROUND Whether the presence of viability drives mortality in patients with ischemic cardiomyopathywho are treated medically and whether the extent of viability is important are issues that arecurrently unclear.METHODS Two hundred sixty-one patients with ischemic cardiomyopathy underwent positron emissiontomography (PET) for assessment of viability. Prospective follow-up was obtained.RESULTS Ninety-four patients were revascularized and 167 were not. The cardiac death rate wassignificantly less in the revascularized patients as compared with medically treated patients(13% vs. 24%, p
0.05). In the revascularized patients, there was a trend toward bettersurvival in patients with viable myocardium as compared with nonviable myocardium(3.5-year survival, 85% and 75% respectively, p  NS). In the medically treated group, age(hazard ratio [HR] 2.1, 95% confidence interval [CI] 1.2 to 3.7), presence of left bundlebranch block (HR 3.4, 95% CI 1.6 to 7.2) and extent of perfusion-metabolism mismatch onPET (HR 1.36, 95% CI 1.1 to 1.6) predicted cardiac death during a median follow-up periodof 2.1 years. The risk of cardiac death was not significantly increased when the extent ofไม่ตรง 20% (HR 0.97, 95% CI 0.46 2.05) แต่อย่างมีนัยสำคัญเพิ่มขึ้นเมื่อขอบเขตไม่ตรงกันคือ 20% (HR 3.21, 95% CI 1.38 7.49)ข้อสรุปทางการแพทย์รักษาผู้ป่วยสำรอก cardiomyopathy และพื้นที่ขนาดใหญ่ของกล้ามเนื้อหัวใจทำงานได้ในสัตว์มีการเสี่ยงสำหรับโรคหัวใจตาย (Cardiol เก็บรวบ Am J 2005; 46:1264 –9)© 2005 โดยมูลนิธิวิทยาลัยโรคหัวใจอเมริกัน