Preoperative prediction of reversible myocardial asynergy by postexercise radionuclide ventriculography

Journal Article · Thu Jul 22 00:00:00 EDT 1982 · N.Engl. J. Med.; (United States)

DOI:https://doi.org/10.1056/NEJM198207223070402· OSTI ID:6726442

Rozanski, A; Berman, D; Gray, R; Diamond, G; Raymond, M; Prause, J; Maddahi, J; Swan, H J; Matloff, J

Myocardial asynergy is sometimes reversed by coronary bypass, and a noninvasive method of predicting which assess are reversible would be desirable. To assess whether changes in myocardial wall motion observed immediately after exercise can differentiate reversible from nonreversible myocardial asynergy, we evaluated 53 patients by radionuclide ventriculography before and after exercise and again at rest after coronary bypass surgery. Preoperative improvement in wall motion immediately after exercise was highly predictive of the surgical outcome (average chance-corrected agreement, 91 per cent). At surgery the asynergic segments that had improved after exercise were free of grossly apparent epicardial scarring. The accuracy of these predictions for postoperative improvement was significantly greater (P less than 0.01) than that of analysis of Q waves on resting electrocardiography (average chance-corrected agreement, 40 per cent). In contrast, preoperative changes in left ventricular ejection fraction after exercise were not predictive of postoperative resting ejection fraction. We conclude that postexercise radionuclide ventriculography can be used to identify reversible resting myocardial asynergy. This test should prove effective in predicting which patients with myocardial asynergy are most likely to benefit from aortocoronary revascularization.

• Research Organization: Divisions of Cardiology and Cardiovascular Surgery, Cedars-Sinai Medical Center, Los Angeles
• OSTI ID: 6726442
• Journal Information: N.Engl. J. Med.; (United States), Journal Name: N.Engl. J. Med.; (United States) Vol. 307:4; ISSN NEJMA
• Country of Publication: United States
• Language: English

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59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DIAGNOSTIC TECHNIQUES
DIAGNOSTIC USES
DISEASES
DRUGS
EXERCISE
HEART
LABELLED COMPOUNDS
MEDICINE
MUSCLES
MYOCARDIUM
ORGANS
PATHOLOGY
PATIENTS
PLANNING
RADIOISOTOPE SCANNING
RADIOPHARMACEUTICALS
SCINTISCANNING
SURGERY
USES