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Myocardial viability on echocardiography predicts long-term survival after revascularization in patients with ischemic congestive heart failure

^a Department of Cardiovascular Medicine, Northwick Park and St. Mark’s Hospitals and Institute of Medical Research, Harrow, United Kingdom
^* Cardiovascular Division, University of Virginia, Charlottesville, Virginia, USA

View larger version (13K): [in a new window]   Figure 1 The 12-segment model used for echocardiographic assessment of resting function and function during DE. Segments 1, 2, 6, 7 and 11 belong to the left anterior descending artery vascular territory. Segments 3 and 8 belong to the left circumflex artery territory. Segments 4, 5, 9 and 10 belong to the right coronary artery territory. Segment 12 belongs to the left anterior descending artery territory, unless it is abnormal in conjunction with other segments of the right coronary artery and not the left anterior descending artery territory, in which case it belongs to the right coronary artery territory.

View larger version (13K): [in a new window]   Figure 2 The receiver-operator characteristic curve showing the sensitivity (x-axis) and 1-specificity (y-axis) of the different cutoff points for the number of segments with MV that needed to be revascularized in order to demonstrate a survival benefit. a = 0 segments, b = 2 versus 3 segments; c = 4 versus 5 segments; d = 5 versus 6 segments; e = 6 versus 7 segments; f = 7 versus 8 segments; g = 8 versus 9 segments; h = 9 versus 10 segments; i = 10 versus 11 segments; j = 11 versus segments; and k = 12 segments.

View larger version (12K): [in a new window]   Figure 3 Event-free survival curves for the four patient groups. See text for details. Solid diamond = revascularization with myocardial viability; solid triangle = medical therapy with myocardial viability; open triangle = medical therapy without myocardial viability; open diamond = revascularization without myocardial viability.