[Cardiac insufficiency of ischemic origin].
Many mechanisms are implicated in the aetiology of ischemic ventricular dysfunction. It could be acute or chronic. Chronic forms are due to post-ischemic state. In this case we can observe left ventricular dysfunction due to myocardial necrosis or associated with hibernation. It is very important to recognise last point because it's reversible after coronary revascularization. Acute ischemic left ventricular dysfunction are essentially due to metabolism abnormality inducing left ventricular adiastoly. In this particular case, when we evaluate the function at distance of the acute episode it could be normal. This particular state is important to be recognised and the indication of coronarography angiography will confirm the diagnosis. Many techniques are available to detect myocardial viability it's essentially radionuclide techniques and echocardiography with dobutamine and also MRI. This last method has the advantage to cumulate the detection of tissular viability and functional viability.
Duboc
Denis
D
Service de cardiologie Hôpital Cochin 75674 Paris. denis.duboc@cch.ap-hop-paris.fr
D002316:Cardiotonic Agents; D004280:Dobutamine; D004452:Echocardiography; D006333:Heart Failure / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D013794:Thallium Radioisotopes; D014055:Tomography, Emission-Computed
D002316:Cardiotonic Agents; D013794:Thallium Radioisotopes; D004280:Dobutamine