Loading…
Assessment of Myocardial Viability in Ischemic Cardiomyopathy With Reduced Left Ventricular Function Undergoing Coronary Artery Bypass Grafting
ABSTRACT Background We aim to provide a comprehensive review of the current state of knowledge of myocardial viability assessment in patients undergoing coronary artery bypass grafting (CABG), with a focus on the clinical markers of viability for each imaging modality. We also compare mortality betw...
Saved in:
| Published in: | Clinical cardiology (Mahwah, N.J.) N.J.), 2024-07, Vol.47 (7), p.e24307-n/a |
|---|---|
| Main Authors: | , , , , , , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | |
|---|---|
| cites | cdi_FETCH-LOGICAL-c3697-35e82159fd5eab80d6042daf2769fdd786f2669b8b72dc119201e2c2f54fdd03 |
| container_end_page | n/a |
| container_issue | 7 |
| container_start_page | e24307 |
| container_title | Clinical cardiology (Mahwah, N.J.) |
| container_volume | 47 |
| creator | Arjomandi Rad, Arian Tserioti, Eleni Magouliotis, Dimitrios E. Vardanyan, Robert Samiotis, Ilias V. Skoularigis, John Ariff, Ben Xanthopoulos, Andrew Triposkiadis, Filippos Casula, Roberto Athanasiou, Thanos |
| description | ABSTRACT
Background
We aim to provide a comprehensive review of the current state of knowledge of myocardial viability assessment in patients undergoing coronary artery bypass grafting (CABG), with a focus on the clinical markers of viability for each imaging modality. We also compare mortality between patients with viable myocardium and those without viability who undergo CABG.
Methods
A systematic database search with meta‐analysis was conducted of comparative original articles (both observations and randomized controlled studies) of patients undergoing CABG with either viable or nonviable myocardium, in EMBASE, MEDLINE, Cochrane database, and Google Scholar, from inception to 2022. Imaging modalities included were dobutamine stress echocardiography (DSE), cardiac magnetic resonance (CMR), single‐photon emission computed tomography (SPECT), and positron emission tomography (PET).
Results
A total of 17 studies incorporating a total of 2317 patients were included. Across all imaging modalities, the relative risk of death post‐CABG was reduced in patients with versus without viability (random‐effects model: odds ratio: 0.42; 95% confidence interval: 0.29–0.61; p |
| doi_str_mv | 10.1002/clc.24307 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11217808</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3084564294</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3697-35e82159fd5eab80d6042daf2769fdd786f2669b8b72dc119201e2c2f54fdd03</originalsourceid><addsrcrecordid>eNp1kd1qFDEYhoModq0eeAMS8EQPps3PzCRzJOtga2FFkFoPQyY_uykzyZpklLkKb9msW4sKHn2Q9-HhDS8AzzE6wwiRczWqM1JTxB6AFe4oqTij7CFYIdyiqiO8OwFPUrotKOKEPgYnlHcNpS1bgR_rlExKk_EZBgs_LEHJqJ0c4Y2TgxtdXqDz8CqpnZmcgv0hDdMS9jLvFvjF5R38ZPSsjIYbYzO8Kabo1DzKCC9mr7ILHn722sRtcH4L-xCDl3GB65hNOW-XvUwJXkZpc8mfgkdWjsk8u7un4Pri3XX_vtp8vLzq15tK0bZjFW0MJ7jprG6MHDjSLaqJlpawtrxpxltL2rYb-MCIVhh3BGFDFLFNXWJET8Gbo3Y_D5PR6lBajmIf3VS6iSCd-Dvxbie24ZvAmGDGES-GV3eGGL7OJmUxuaTMOEpvwpxEWaOhrJSgBX35D3ob5ujL9wrF66atSVcX6vWRUjGkFI29b4OROMwsyszi18yFffFn_Xvy964FOD8C391olv-bRL_pj8qfD5m0tA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3084564294</pqid></control><display><type>article</type><title>Assessment of Myocardial Viability in Ischemic Cardiomyopathy With Reduced Left Ventricular Function Undergoing Coronary Artery Bypass Grafting</title><source>Open Access: PubMed Central</source><source>Open Access: Wiley-Blackwell Open Access Journals</source><source>Publicly Available Content (ProQuest)</source><creator>Arjomandi Rad, Arian ; Tserioti, Eleni ; Magouliotis, Dimitrios E. ; Vardanyan, Robert ; Samiotis, Ilias V. ; Skoularigis, John ; Ariff, Ben ; Xanthopoulos, Andrew ; Triposkiadis, Filippos ; Casula, Roberto ; Athanasiou, Thanos</creator><creatorcontrib>Arjomandi Rad, Arian ; Tserioti, Eleni ; Magouliotis, Dimitrios E. ; Vardanyan, Robert ; Samiotis, Ilias V. ; Skoularigis, John ; Ariff, Ben ; Xanthopoulos, Andrew ; Triposkiadis, Filippos ; Casula, Roberto ; Athanasiou, Thanos</creatorcontrib><description>ABSTRACT
Background
We aim to provide a comprehensive review of the current state of knowledge of myocardial viability assessment in patients undergoing coronary artery bypass grafting (CABG), with a focus on the clinical markers of viability for each imaging modality. We also compare mortality between patients with viable myocardium and those without viability who undergo CABG.
Methods
A systematic database search with meta‐analysis was conducted of comparative original articles (both observations and randomized controlled studies) of patients undergoing CABG with either viable or nonviable myocardium, in EMBASE, MEDLINE, Cochrane database, and Google Scholar, from inception to 2022. Imaging modalities included were dobutamine stress echocardiography (DSE), cardiac magnetic resonance (CMR), single‐photon emission computed tomography (SPECT), and positron emission tomography (PET).
Results
A total of 17 studies incorporating a total of 2317 patients were included. Across all imaging modalities, the relative risk of death post‐CABG was reduced in patients with versus without viability (random‐effects model: odds ratio: 0.42; 95% confidence interval: 0.29–0.61; p < 0.001). Imaging for myocardial viability has significant clinical implications as it can affect the accuracy of the diagnosis, guide treatment decisions, and predict patient outcomes. Generally, based on local availability and expertise, either SPECT or DSE should be considered as the first step in evaluating viability, while PET or CMR would provide further evaluation of transmurality, perfusion metabolism, and extent of scar tissue.
Conclusion
The assessment of myocardial viability is an essential component of preoperative evaluation in patients with ischemic heart disease undergoing surgical revascularization. Careful patient selection and individualized assessment of viability remain paramount.
This graphical illustrates the assessment of myocardial viability using various imaging modalities (single‐photon emission computed tomography, dobutamine stress echocardiography, cardiac magnetic resonance, positron emission tomography) for patients undergoing coronary artery bypass grafting. It details the criteria for viable and potentially viable myocardium and highlights the importance of these assessments in guiding treatment decisions and predicting patient outcomes. Key clinical considerations and evidence for myocardial viability are also presented.</description><identifier>ISSN: 0160-9289</identifier><identifier>ISSN: 1932-8737</identifier><identifier>EISSN: 1932-8737</identifier><identifier>DOI: 10.1002/clc.24307</identifier><identifier>PMID: 38953367</identifier><language>eng</language><publisher>United States: John Wiley & Sons, Inc</publisher><subject>CABG ; Cardiomyopathies - diagnosis ; Cardiomyopathies - etiology ; Cardiomyopathies - physiopathology ; Cardiomyopathies - surgery ; Cardiomyopathy ; Cardiovascular disease ; Clinical outcomes ; Content analysis ; Coronary Artery Bypass - adverse effects ; Coronary Artery Disease - complications ; Coronary Artery Disease - diagnosis ; Coronary Artery Disease - physiopathology ; Coronary Artery Disease - surgery ; Coronary vessels ; Echocardiography, Stress - methods ; Ejection fraction ; heart failure ; Heart surgery ; Humans ; Ischemia ; Metabolism ; Mortality ; Myocardial Ischemia - complications ; Myocardial Ischemia - diagnosis ; Myocardial Ischemia - physiopathology ; Myocardial Ischemia - surgery ; myocardial viability ; Myocardium - pathology ; Observational studies ; Patients ; Review ; Reviews ; Tissue Survival ; Tomography ; Tomography, Emission-Computed, Single-Photon ; Ultrasonic imaging ; Vein & artery diseases ; Ventricular Dysfunction, Left - etiology ; Ventricular Dysfunction, Left - physiopathology ; Ventricular Function, Left - physiology</subject><ispartof>Clinical cardiology (Mahwah, N.J.), 2024-07, Vol.47 (7), p.e24307-n/a</ispartof><rights>2024 The Author(s). published by Wiley Periodicals LLC.</rights><rights>2024 The Author(s). Clinical Cardiology published by Wiley Periodicals LLC.</rights><rights>2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3697-35e82159fd5eab80d6042daf2769fdd786f2669b8b72dc119201e2c2f54fdd03</cites><orcidid>0000-0002-4931-4049</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/3084564294/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/3084564294?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,11541,25731,27901,27902,36989,36990,44566,46027,46451,53766,53768,74869</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38953367$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Arjomandi Rad, Arian</creatorcontrib><creatorcontrib>Tserioti, Eleni</creatorcontrib><creatorcontrib>Magouliotis, Dimitrios E.</creatorcontrib><creatorcontrib>Vardanyan, Robert</creatorcontrib><creatorcontrib>Samiotis, Ilias V.</creatorcontrib><creatorcontrib>Skoularigis, John</creatorcontrib><creatorcontrib>Ariff, Ben</creatorcontrib><creatorcontrib>Xanthopoulos, Andrew</creatorcontrib><creatorcontrib>Triposkiadis, Filippos</creatorcontrib><creatorcontrib>Casula, Roberto</creatorcontrib><creatorcontrib>Athanasiou, Thanos</creatorcontrib><title>Assessment of Myocardial Viability in Ischemic Cardiomyopathy With Reduced Left Ventricular Function Undergoing Coronary Artery Bypass Grafting</title><title>Clinical cardiology (Mahwah, N.J.)</title><addtitle>Clin Cardiol</addtitle><description>ABSTRACT
Background
We aim to provide a comprehensive review of the current state of knowledge of myocardial viability assessment in patients undergoing coronary artery bypass grafting (CABG), with a focus on the clinical markers of viability for each imaging modality. We also compare mortality between patients with viable myocardium and those without viability who undergo CABG.
Methods
A systematic database search with meta‐analysis was conducted of comparative original articles (both observations and randomized controlled studies) of patients undergoing CABG with either viable or nonviable myocardium, in EMBASE, MEDLINE, Cochrane database, and Google Scholar, from inception to 2022. Imaging modalities included were dobutamine stress echocardiography (DSE), cardiac magnetic resonance (CMR), single‐photon emission computed tomography (SPECT), and positron emission tomography (PET).
Results
A total of 17 studies incorporating a total of 2317 patients were included. Across all imaging modalities, the relative risk of death post‐CABG was reduced in patients with versus without viability (random‐effects model: odds ratio: 0.42; 95% confidence interval: 0.29–0.61; p < 0.001). Imaging for myocardial viability has significant clinical implications as it can affect the accuracy of the diagnosis, guide treatment decisions, and predict patient outcomes. Generally, based on local availability and expertise, either SPECT or DSE should be considered as the first step in evaluating viability, while PET or CMR would provide further evaluation of transmurality, perfusion metabolism, and extent of scar tissue.
Conclusion
The assessment of myocardial viability is an essential component of preoperative evaluation in patients with ischemic heart disease undergoing surgical revascularization. Careful patient selection and individualized assessment of viability remain paramount.
This graphical illustrates the assessment of myocardial viability using various imaging modalities (single‐photon emission computed tomography, dobutamine stress echocardiography, cardiac magnetic resonance, positron emission tomography) for patients undergoing coronary artery bypass grafting. It details the criteria for viable and potentially viable myocardium and highlights the importance of these assessments in guiding treatment decisions and predicting patient outcomes. Key clinical considerations and evidence for myocardial viability are also presented.</description><subject>CABG</subject><subject>Cardiomyopathies - diagnosis</subject><subject>Cardiomyopathies - etiology</subject><subject>Cardiomyopathies - physiopathology</subject><subject>Cardiomyopathies - surgery</subject><subject>Cardiomyopathy</subject><subject>Cardiovascular disease</subject><subject>Clinical outcomes</subject><subject>Content analysis</subject><subject>Coronary Artery Bypass - adverse effects</subject><subject>Coronary Artery Disease - complications</subject><subject>Coronary Artery Disease - diagnosis</subject><subject>Coronary Artery Disease - physiopathology</subject><subject>Coronary Artery Disease - surgery</subject><subject>Coronary vessels</subject><subject>Echocardiography, Stress - methods</subject><subject>Ejection fraction</subject><subject>heart failure</subject><subject>Heart surgery</subject><subject>Humans</subject><subject>Ischemia</subject><subject>Metabolism</subject><subject>Mortality</subject><subject>Myocardial Ischemia - complications</subject><subject>Myocardial Ischemia - diagnosis</subject><subject>Myocardial Ischemia - physiopathology</subject><subject>Myocardial Ischemia - surgery</subject><subject>myocardial viability</subject><subject>Myocardium - pathology</subject><subject>Observational studies</subject><subject>Patients</subject><subject>Review</subject><subject>Reviews</subject><subject>Tissue Survival</subject><subject>Tomography</subject><subject>Tomography, Emission-Computed, Single-Photon</subject><subject>Ultrasonic imaging</subject><subject>Vein & artery diseases</subject><subject>Ventricular Dysfunction, Left - etiology</subject><subject>Ventricular Dysfunction, Left - physiopathology</subject><subject>Ventricular Function, Left - physiology</subject><issn>0160-9289</issn><issn>1932-8737</issn><issn>1932-8737</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>PIMPY</sourceid><recordid>eNp1kd1qFDEYhoModq0eeAMS8EQPps3PzCRzJOtga2FFkFoPQyY_uykzyZpklLkKb9msW4sKHn2Q9-HhDS8AzzE6wwiRczWqM1JTxB6AFe4oqTij7CFYIdyiqiO8OwFPUrotKOKEPgYnlHcNpS1bgR_rlExKk_EZBgs_LEHJqJ0c4Y2TgxtdXqDz8CqpnZmcgv0hDdMS9jLvFvjF5R38ZPSsjIYbYzO8Kabo1DzKCC9mr7ILHn722sRtcH4L-xCDl3GB65hNOW-XvUwJXkZpc8mfgkdWjsk8u7un4Pri3XX_vtp8vLzq15tK0bZjFW0MJ7jprG6MHDjSLaqJlpawtrxpxltL2rYb-MCIVhh3BGFDFLFNXWJET8Gbo3Y_D5PR6lBajmIf3VS6iSCd-Dvxbie24ZvAmGDGES-GV3eGGL7OJmUxuaTMOEpvwpxEWaOhrJSgBX35D3ob5ujL9wrF66atSVcX6vWRUjGkFI29b4OROMwsyszi18yFffFn_Xvy964FOD8C391olv-bRL_pj8qfD5m0tA</recordid><startdate>202407</startdate><enddate>202407</enddate><creator>Arjomandi Rad, Arian</creator><creator>Tserioti, Eleni</creator><creator>Magouliotis, Dimitrios E.</creator><creator>Vardanyan, Robert</creator><creator>Samiotis, Ilias V.</creator><creator>Skoularigis, John</creator><creator>Ariff, Ben</creator><creator>Xanthopoulos, Andrew</creator><creator>Triposkiadis, Filippos</creator><creator>Casula, Roberto</creator><creator>Athanasiou, Thanos</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-4931-4049</orcidid></search><sort><creationdate>202407</creationdate><title>Assessment of Myocardial Viability in Ischemic Cardiomyopathy With Reduced Left Ventricular Function Undergoing Coronary Artery Bypass Grafting</title><author>Arjomandi Rad, Arian ; Tserioti, Eleni ; Magouliotis, Dimitrios E. ; Vardanyan, Robert ; Samiotis, Ilias V. ; Skoularigis, John ; Ariff, Ben ; Xanthopoulos, Andrew ; Triposkiadis, Filippos ; Casula, Roberto ; Athanasiou, Thanos</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3697-35e82159fd5eab80d6042daf2769fdd786f2669b8b72dc119201e2c2f54fdd03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>CABG</topic><topic>Cardiomyopathies - diagnosis</topic><topic>Cardiomyopathies - etiology</topic><topic>Cardiomyopathies - physiopathology</topic><topic>Cardiomyopathies - surgery</topic><topic>Cardiomyopathy</topic><topic>Cardiovascular disease</topic><topic>Clinical outcomes</topic><topic>Content analysis</topic><topic>Coronary Artery Bypass - adverse effects</topic><topic>Coronary Artery Disease - complications</topic><topic>Coronary Artery Disease - diagnosis</topic><topic>Coronary Artery Disease - physiopathology</topic><topic>Coronary Artery Disease - surgery</topic><topic>Coronary vessels</topic><topic>Echocardiography, Stress - methods</topic><topic>Ejection fraction</topic><topic>heart failure</topic><topic>Heart surgery</topic><topic>Humans</topic><topic>Ischemia</topic><topic>Metabolism</topic><topic>Mortality</topic><topic>Myocardial Ischemia - complications</topic><topic>Myocardial Ischemia - diagnosis</topic><topic>Myocardial Ischemia - physiopathology</topic><topic>Myocardial Ischemia - surgery</topic><topic>myocardial viability</topic><topic>Myocardium - pathology</topic><topic>Observational studies</topic><topic>Patients</topic><topic>Review</topic><topic>Reviews</topic><topic>Tissue Survival</topic><topic>Tomography</topic><topic>Tomography, Emission-Computed, Single-Photon</topic><topic>Ultrasonic imaging</topic><topic>Vein & artery diseases</topic><topic>Ventricular Dysfunction, Left - etiology</topic><topic>Ventricular Dysfunction, Left - physiopathology</topic><topic>Ventricular Function, Left - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Arjomandi Rad, Arian</creatorcontrib><creatorcontrib>Tserioti, Eleni</creatorcontrib><creatorcontrib>Magouliotis, Dimitrios E.</creatorcontrib><creatorcontrib>Vardanyan, Robert</creatorcontrib><creatorcontrib>Samiotis, Ilias V.</creatorcontrib><creatorcontrib>Skoularigis, John</creatorcontrib><creatorcontrib>Ariff, Ben</creatorcontrib><creatorcontrib>Xanthopoulos, Andrew</creatorcontrib><creatorcontrib>Triposkiadis, Filippos</creatorcontrib><creatorcontrib>Casula, Roberto</creatorcontrib><creatorcontrib>Athanasiou, Thanos</creatorcontrib><collection>Open Access: Wiley-Blackwell Open Access Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content (ProQuest)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical cardiology (Mahwah, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Arjomandi Rad, Arian</au><au>Tserioti, Eleni</au><au>Magouliotis, Dimitrios E.</au><au>Vardanyan, Robert</au><au>Samiotis, Ilias V.</au><au>Skoularigis, John</au><au>Ariff, Ben</au><au>Xanthopoulos, Andrew</au><au>Triposkiadis, Filippos</au><au>Casula, Roberto</au><au>Athanasiou, Thanos</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessment of Myocardial Viability in Ischemic Cardiomyopathy With Reduced Left Ventricular Function Undergoing Coronary Artery Bypass Grafting</atitle><jtitle>Clinical cardiology (Mahwah, N.J.)</jtitle><addtitle>Clin Cardiol</addtitle><date>2024-07</date><risdate>2024</risdate><volume>47</volume><issue>7</issue><spage>e24307</spage><epage>n/a</epage><pages>e24307-n/a</pages><issn>0160-9289</issn><issn>1932-8737</issn><eissn>1932-8737</eissn><abstract>ABSTRACT
Background
We aim to provide a comprehensive review of the current state of knowledge of myocardial viability assessment in patients undergoing coronary artery bypass grafting (CABG), with a focus on the clinical markers of viability for each imaging modality. We also compare mortality between patients with viable myocardium and those without viability who undergo CABG.
Methods
A systematic database search with meta‐analysis was conducted of comparative original articles (both observations and randomized controlled studies) of patients undergoing CABG with either viable or nonviable myocardium, in EMBASE, MEDLINE, Cochrane database, and Google Scholar, from inception to 2022. Imaging modalities included were dobutamine stress echocardiography (DSE), cardiac magnetic resonance (CMR), single‐photon emission computed tomography (SPECT), and positron emission tomography (PET).
Results
A total of 17 studies incorporating a total of 2317 patients were included. Across all imaging modalities, the relative risk of death post‐CABG was reduced in patients with versus without viability (random‐effects model: odds ratio: 0.42; 95% confidence interval: 0.29–0.61; p < 0.001). Imaging for myocardial viability has significant clinical implications as it can affect the accuracy of the diagnosis, guide treatment decisions, and predict patient outcomes. Generally, based on local availability and expertise, either SPECT or DSE should be considered as the first step in evaluating viability, while PET or CMR would provide further evaluation of transmurality, perfusion metabolism, and extent of scar tissue.
Conclusion
The assessment of myocardial viability is an essential component of preoperative evaluation in patients with ischemic heart disease undergoing surgical revascularization. Careful patient selection and individualized assessment of viability remain paramount.
This graphical illustrates the assessment of myocardial viability using various imaging modalities (single‐photon emission computed tomography, dobutamine stress echocardiography, cardiac magnetic resonance, positron emission tomography) for patients undergoing coronary artery bypass grafting. It details the criteria for viable and potentially viable myocardium and highlights the importance of these assessments in guiding treatment decisions and predicting patient outcomes. Key clinical considerations and evidence for myocardial viability are also presented.</abstract><cop>United States</cop><pub>John Wiley & Sons, Inc</pub><pmid>38953367</pmid><doi>10.1002/clc.24307</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-4931-4049</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0160-9289 |
| ispartof | Clinical cardiology (Mahwah, N.J.), 2024-07, Vol.47 (7), p.e24307-n/a |
| issn | 0160-9289 1932-8737 1932-8737 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11217808 |
| source | Open Access: PubMed Central; Open Access: Wiley-Blackwell Open Access Journals; Publicly Available Content (ProQuest) |
| subjects | CABG Cardiomyopathies - diagnosis Cardiomyopathies - etiology Cardiomyopathies - physiopathology Cardiomyopathies - surgery Cardiomyopathy Cardiovascular disease Clinical outcomes Content analysis Coronary Artery Bypass - adverse effects Coronary Artery Disease - complications Coronary Artery Disease - diagnosis Coronary Artery Disease - physiopathology Coronary Artery Disease - surgery Coronary vessels Echocardiography, Stress - methods Ejection fraction heart failure Heart surgery Humans Ischemia Metabolism Mortality Myocardial Ischemia - complications Myocardial Ischemia - diagnosis Myocardial Ischemia - physiopathology Myocardial Ischemia - surgery myocardial viability Myocardium - pathology Observational studies Patients Review Reviews Tissue Survival Tomography Tomography, Emission-Computed, Single-Photon Ultrasonic imaging Vein & artery diseases Ventricular Dysfunction, Left - etiology Ventricular Dysfunction, Left - physiopathology Ventricular Function, Left - physiology |
| title | Assessment of Myocardial Viability in Ischemic Cardiomyopathy With Reduced Left Ventricular Function Undergoing Coronary Artery Bypass Grafting |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-09T07%3A00%3A08IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Assessment%20of%20Myocardial%20Viability%20in%20Ischemic%20Cardiomyopathy%20With%20Reduced%20Left%20Ventricular%20Function%20Undergoing%20Coronary%20Artery%20Bypass%20Grafting&rft.jtitle=Clinical%20cardiology%20(Mahwah,%20N.J.)&rft.au=Arjomandi%20Rad,%20Arian&rft.date=2024-07&rft.volume=47&rft.issue=7&rft.spage=e24307&rft.epage=n/a&rft.pages=e24307-n/a&rft.issn=0160-9289&rft.eissn=1932-8737&rft_id=info:doi/10.1002/clc.24307&rft_dat=%3Cproquest_pubme%3E3084564294%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c3697-35e82159fd5eab80d6042daf2769fdd786f2669b8b72dc119201e2c2f54fdd03%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=3084564294&rft_id=info:pmid/38953367&rfr_iscdi=true |