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Elevated serum Troponin I (cTnl) predicts poor prognosis in patients (pts) with unstable angina (UA). However, this observation has not been correlated to echocardiographic wall motion abnormality (WMA), a marker of infarcted, ischemic, stunned or hibernating myocardium. To compare the predictive value of elevated cTnl with that of WMA for major cardiac events, we analyzed the data on 109 consecutive...
While echocardiography (2DE) is often used to evaluate patients (pts) with syncope its utility in this area is not well defined. Indeed, the current ACC/AHA Guidelines for the Clinical Application of Echocardiography note a ''strong need'' for a large prospective study in this area. To address this issue, 258 consecutive pts (age 67 +/- 18 yrs) admitted to the emergency department with syncope were...
Prior studies from our laboratory have shown that ongoing myocyte death through apoptosis occurs in hibernating myocardium (HM). This study was designed to assess whether reperfusion after 7 days of severe coronary stenosis affects apoptosis in HM.Methods: Three groups of pigs were studied. In group 1 (n = 6) a fixed LAD stenosis was created, reducing LAD flow from 0.94 +/- 0.11 to 0.56 +/- 0.11...
The natural history of regional LV function following primary angioplasty (PA) has not been well studied. Therefore, 33 pts (58 +/- 14 years, 19 males) undergoing PA were studied with echocardiography early (<12 hrs post PA) and at a follow-up of 48 +/- 80 days.Methods: Two readers blinded to study sequence assessed early and late LV systolic function using a 16-segment model on a 1-4 scoring...
We have previously shown that LV remodeling occurs in hibernating myocardium (HM), with wall thinning related to slippage of myocyte bundles and myocyte hypertrophy. To study whether reperfusion reverses these cellular changes, we created a LAD stenosis to reduce flow by 40% 5 pigs, producing severe regional LV dysfunction. At 7 days LV biopsies were taken from the hibernating and normal regions;...
Myocardial contrast perfusion echocardiography (MCE) has been used to assess myocardial viability in patients with ischemic LV dysfunction. To evaluate its ability to assess myocardial blood flow (MBF) in hibernating myocardium (HM), MCE was performed at 13 levels of reduced MBF in 6 pigs with HM (1 to 4 wks).Methods: The model of HM was created with a left anterior descending coronary stenosis to...
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