Relationship between myocardial viability and coronary run-off in jeopardized myocardium.
OBJECTIVE
The aim of this study was to evaluate the relationship between coronary run-off and myocardial viability in jeopardized regions.


METHODS
We studied 50 patients (40 male, mean age: 55.63 +/- 10.54 years) with coronary artery stenosis >70% and ejection fraction <40% referred for viability study via dobutamine stress echocardiography. The relationship between coronary run-off and viability was evaluated. Good run-off demonstrates good or moderate and no run-off means poor or no run-off.


RESULTS
In the apical region, 33% of the segments with good antegrade run-off were viable and 67% nonviable. Also, 72% of the segments with no run-off were nonviable and 28% viable. In the midportion region, 70% of the segments with good antegrade run-off were viable and 30% nonviable; 50% of the segments with no run-off were nonviable and 50% viable. In the basal region, 85% of the segments with good antegrade run-off were viable and 15% nonviable; 19% of the segments with no run-off were nonviable and 81% viable. The proportion of the nonviable segments increased significantly from the basal to apical regions either with good (p < 0.001) or no run-off (p = 0.004). From 239 viable segments, 58.6% had antegrade, 15.4% retrograde, and 25.5% no run-off. Of 181 nonviable segments, 44% had antegrade, 34% retrograde, and 34.8% no run-off.


CONCLUSIONS
There was more susceptibility to nonviability in the apical regions despite good run-off, while the basal segments showed more viability in spite of having no run-off. The findings may be helpful for selecting patients with coronary artery disease and left ventricular systolic dysfunction that benefit from revascularization.
Sadeghian
Hakimeh
H
Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. sadeghianhakimeh@yahoo.com
Nematipour
Ebrahim
E
Lotfi-Tokaldany
Masoumeh
M
Sheikhfathollahi
Mahmood
M
Sadeghian
Saeed
S
Darabian
Sirous
S
Abbasi
Seyed Hesameddin
SH
Jahangiri
Sirous
S
D000328:Adult; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000473:pathology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D025401:Echocardiography, Stress; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011446:Prospective Studies; D013318:Stroke Volume; D014022:Tissue Survival; D016277:Ventricular Function, Left