Cardiovascular Revascularization Medicine
Volume 11, Issue 1 , Pages 2-7, January 2010

Predictors of myocardial contractile recovery after coronary revascularization in patients with prior myocardial infarction

  • Zainab Abdel-Salam
    • ,
  • Wail Nammas

      Affiliations

    • Corresponding Author InformationCorresponding author. Cardiology Department, Ain Shams University Hospitals, Faculty of Medicine, Ain Shams University, Abbassia, P.O. Box 11381, Cairo, Egypt. Tel.: +20 12 4063718; fax: +20 2 24820416.

Cardiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Received 22 November 2008; received in revised form 4 January 2009; accepted 9 January 2009.

Abstract 

Background

We sought to explore the prognostic power of certain patient characteristics to predict myocardial contractile recovery after coronary revascularization in patients with prior myocardial infarction.

Methods and Materials

We enrolled 100 consecutive patients with prior myocardial infarction, significant coronary stenosis/occlusion amenable for revascularization, and regional wall motion abnormality in the distribution of the affected artery. All patients underwent echocardiographic assessment of regional wall motion and left ventricular ejection fraction. Patients underwent coronary revascularization by either percutaneous angioplasty or surgical bypass. Echocardiography was repeated 8 weeks following revascularization. Patients were classified into two groups: Group 1 with evidence of contractile improvement after revascularization at follow-up echocardiography and Group 2 with no such evidence of improvement. The two groups were compared with respect to patients' clinical characteristics and echocardiographic and angiographic data.

Results

Predictors of contractile recovery after revascularization included angina pectoris, the shorter age of infarction at the time of revascularization, a higher baseline left ventricular ejection fraction, a lower baseline wall motion score index, the presence of Grade 2–3 collaterals to the infarct-related artery, and the absence of dyspnea or diabetes mellitus. Stepwise regression analysis identified the presence of Grade 2–3 collaterals to the infarct-related artery and the age of infarction at the time of revascularization as independent predictors of contractile recovery after revascularization.

Conclusions

In patients with prior myocardial infarction, the presence of Grade 2–3 collaterals to the infarct-related artery and the shorter age of infarction at the time of revascularization independently predicted myocardial contractile recovery after coronary revascularization.

Keywords: Predictors, Viability, Revascularization, Myocardial infarction

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PII: S1553-8389(09)00038-4

doi:10.1016/j.carrev.2009.01.003

Cardiovascular Revascularization Medicine
Volume 11, Issue 1 , Pages 2-7, January 2010

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