Coronary revascularization in patients with ischemic left ventricular dysfunction
Journal Title: Moldovan Medical Journal - Year 2018, Vol 61, Issue 3
Abstract
Background: Coronary artery disease (CAD) dominates in the contemporary world among the causes of left ventricular dysfunction (LVD). Prognosis of survival and the course of heart failure (HF) are worse in patients with CAD than in many kinds of non-ischemic cardiomyopathy. Development of cardiac surgery technologies and formation of the relevant evidence base have significantly expanded the role of revascularization in patients with CAD and reduced left ventricular ejection fraction (LVEF). The possibility and expediency of coronary artery bypass grafting (CABG) for improving left ventricular ejection fraction (LVEF), clinical course of HF and survival are evidence-based. Stenting is less effective than coronary artery bypass grafting (CABG) regarding the influence on primary endpoints but improves the quality of life of patients with CAD and ischemic LVD. Conclusions: In patients with ischemic LVD, surgical revascularization can ensure an improvement in the pumping function of the heart, provided there is a sufficient amount of viable myocardium. From the standpoint of evidence-based medicine, the effectiveness of CABG surgery in patients with multivessel lesion of the coronary bed and LVD has been proven for correction LVEF, improvement of the course of the disease and prediction of survival compared with the optimal drug therapy. Percutaneous intervention is inferior to surgical revascularization in terms of its effect on endpoints, but it can make an improvement in the quality of life of patients with ischemic LVD. Evaluation of myocardial viability may be of additional importance for the decision on the feasibility of CABG in the presence of multivessel coronary artery disease combined with a sharp decrease in LVEF.
Authors and Affiliations
Оlga Yepanchintseva, Natalia Ivanyuk, Yulia Borkhalenko, Оleg Zharinov, Borys Тоdurov
Keywords
Related Articles
- EP ID EP480555
- DOI 10.5281/zenodo.1456894
- Views 202
- Downloads 0
Selection of antihypertensive drugs from the perspective of clinical pharmacology
Background: The rational use of medicines remains one of the most important directions of public health, especially in socio-medical diseases, including arterial hypertension. Material and methods: The study involved 28...
Distortion products of otoacoustic emissions and their role in assessing hearing loss in young children
Background: Hearing loss in children is far beyond the scope of otology, since audition is the basis of developing speech and cognitive abilities, as well as the child’s personality. Due to its incidence and severe conse...
About causes of early-stage asymptomatic prostate cancer
Background: The neurotransmitters (epinephrine and norepinephrine) of the sympathetic nervous system that perform numerous cellular and tissue functions contribute to tumor growth during the early stages of development....
Aqueous humor's biochemical composition in ocular pathologies
Background: Being analogous to a blood surrogate, the aqueous humor has an important role in the regulation of the homeostasis of the ocular tissues. It has many functions: provides nutrition, removes excretory products,...
Fetal and neonatal complications of diabetic pregnancy
Background: There is currently convincing clinical and experimental evidence that a hyperglycemic intrauterine environment is responsible not only for significant short-term outcomes in the fetus and newborn infant, but...