Evidence map›Paper›PMID 30364760›Full record

ArticleJournal of geriatric cardiology : JGC2018

Single-territory incomplete surgical revascularization improves regional wall motion of remote ventricular areas: results from a propensity-matched study.

Cristiano Spadaccio, Antonio Nenna, Francesco Nappi, Raffaele Barbato, Salvatore Matteo Greco, Annunziata Nusca, Luigi Sommariva, Massimo Chello

Abstract read
In one paragraph

Article in Journal of geriatric cardiology : JGC, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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0cells of the map it votes in
3citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Cristiano SpadaccioDepartment of Cardiovascular Surgery, Università Campus Bio-Medico di Roma, Rome, Italy.
Antonio NennaDepartment of Cardiovascular Surgery, Università Campus Bio-Medico di Roma, Rome, Italy.
Francesco NappiDepartment of Cardiac Surgery, Centre Cardiologique du Nord, Saint Denis, Paris, France.
Raffaele BarbatoDepartment of Cardiovascular Surgery, Università Campus Bio-Medico di Roma, Rome, Italy.
Salvatore Matteo GrecoDepartment of Cardiovascular Surgery, Università Campus Bio-Medico di Roma, Rome, Italy.
Annunziata NuscaDepartment of Cardiology, Università Campus Bio-Medico di Roma, Rome, Italy.
Luigi SommarivaDepartment of Cardiology, Belcolle Hospital, Viterbo, Italy.
Massimo ChelloDepartment of Cardiovascular Surgery, Università Campus Bio-Medico di Roma, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveBasic science studies demonstrated a general intramyocardial angiogenetic response potentially responsible for the creation of a microvascular neocapillaries network assisting myocardial function. We hypothesized that the benefit provided by the reperfusion of left anterior descending (LAD) territories and the biological angiogenetic drive triggered by the revascularization could translate in a global improvement in ventricular contractility, not restricted to the grafted area.

methodsHigh-risk patients with multivessel coronary artery disease and preoperative wall motion abnormalities were retrospectively analyzed to compare outcomes and regional ventricular function of those who received optimal medical therapy (OMT) versus those who underwent off-pump coronary artery bypass grafting (OPCABG) and received an incomplete myocardial revascularization using left internal mammary artery (LIMA) on LAD (OPCABG group). From January 2007 to December 2014, 206 patients (OMT,

resultsRegional analysis of ventricular function revealed a regional WMSI improvement in the OPCABG group not only for LAD territories but also for non-LAD regions, associated with a reduction in the negative left ventricular ischemic remodeling, compared to patients discharged in optimal medical therapy. Global ΔWMSI was negative in OPCABG group (-3.4 ± 2.8%) and positive in the OMT group (5.9 ± 3.1%), indicating a better wall motion score for OPCAB patients. Surprisingly, regional WMSI improved also in non-grafted territories in the off-pump CABG group with a delta value of -3.7 ± 5.3% for left circumflex artery (LCX) area and -3.5 ± 5.4% for right coronary artery (RCA) area.

conclusionsIn patients with multivessel coronary artery disease, LIMA-to-LAD grafting is associated with an improvement in the WMSI involving also the surrounding non-LAD ungrafted segments and with the attenuation of negative global and regional ischemic ventricular remodeling.

Indexed as

Cardiac surgeryCoronary artery bypass graftIncomplete revascularizationWall motion score index

Identifiers

PMID30364760
PMCPMC6198266

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