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Ischaemic cardiomyopathy: pathophysiology, assessment and the role of revascularisation
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Ischaemic cardiomyopathy: pathophysiology, assessment and the role of revascularisation
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Journal Article
Ischaemic cardiomyopathy: pathophysiology, assessment and the role of revascularisation
2016
Overview
Ischaemic cardiomyopathy: adaptation versus pathology ICM consists of a spectrum of pathophysiological states that relate to perfusion contraction matching and mismatching. 15 An ischaemia model in conscious dogs in the 1980s demonstrated a correlation between myocardial blood flow and regional contractile function, with only small reductions in flow resulting in significant reductions in regional myocardial function. 16 It has also been shown that coronary flow reserve is reduced and changes in metabolism are seen in areas of myocardium subtended by normal coronary arteries in patients with chronic stable angina secondary to coronary stenoses, 17 indicating that areas of myocardium remote from ischaemia are also impacted. Many historical observational studies have shown a mortality benefit in patients with ICM undergoing revascularisation, however the largest randomised study to date, STICH, was negative in terms of its primary end point. [...]at present there are no randomised trial data to support revascularisation in patients with ICM who do not have significant angina or an acute coronary syndrome.
Publisher
BMJ Publishing Group LTD
Subject
/ Cardiomyopathies - diagnosis
/ Cardiomyopathies - mortality
/ Cardiomyopathies - physiopathology
/ Diagnostic Imaging - methods
/ Humans
/ Myocardial Ischemia - complications
/ Myocardial Ischemia - diagnosis
/ Myocardial Ischemia - mortality
/ Myocardial Ischemia - physiopathology
/ Myocardial Ischemia - therapy
/ Myocardial Revascularization - adverse effects
/ Myocardial Revascularization - methods
/ Myocardial Revascularization - mortality
/ Rodents
