BACKGROUND Angiotensin-converting-enzyme (ACE) inhibitors are effective in reducing the risk of heart failure, myocardial infarction, and death from cardiovascular causes in patients with left ventricular systolic dysfunction or heart failure. ACE inhibitors have also been shown to reduce atherosclerotic complications in patients who have vascular disease without heart failure. METHODS In the...

OBJECTIVES To investigate the therapeutic impact of combining extracorporeal membrane oxygenation (ECMO) and early coronary revascularization on acute myocardial infarction (AMI)-induced cardiopulmonary collapse. MATERIALS AND METHODS This retrospective study included 35 consecutive patients rescued by ECMO for AMI-induced cardiopulmonary collapse in a single institution between June 2003 and...

  Introduction: Percutaneous transluminal coronary angioplasty (PTCA) is an effective method for revascularizing of stenotic coronary vessels. Lack of response to this treatment, either in symptomatic or asymptomatic patients, is usually due to incomplete revascularization, restenosis, and/or irreversibility of myocardial perfusion. Introduction of a noninvasive metho...

OBJECTIVES This study pools data from published series examining late survival with revascularization versus medical therapy after myocardial viability testing in patients with severe coronary artery disease (CAD) and left ventricular (LV) dysfunction. BACKGROUND Previous observational studies have suggested survival benefit in such patients if they are revascularized when myocardial viability ...

BACKGROUND Our aim was to determine whether regional left ventricular (LV) function on a resting transthoracic echo (TTE) provides prognostic information in patients with varying degrees of ischemia on myocardial perfusion imaging. METHODS Between 2004 - 2009, we identified 503 patients (mean age 69 (SD 11); 79% male) with reversible ischemia on a myocardial SPECT scan who had a TTE within 30...

BACKGROUND The optimal timing of surgical revascularization for patients presenting with ST-segment elevation myocardial infarction (STEMI) and impaired left ventricular function is not well established. This study aimed to examine the timing of surgical revascularization after STEMI in patients with ischemic heart disease and left ventricular dysfunction (LVD) by comparing early and late resul...

Myocardium to Myocardial Structure in Humans To the Editor: Nagueh and colleagues1 investigated the relationship between myocardial ultrastructure and the inotropic contractile reserve of the hibernating myocardium. They suggested that the amount of interstitial fibrosis in a dysfunctional myocardial segment is an important determinant of both inotropic contractile reserve during dobutamine sti...

OBJECTIVES Although ischemic electrocardiographic (ECG) changes during dipyridamole or adenosine infusion have been reported as a marker for severe coronary artery disease (CAD), few studies have focused on ST-segment changes with adenosine triphosphate (ATP)-loading myocardial single-photon emission computed tomography (SPECT). METHODS AND SUBJECTS Between January 2003 and August 2008, 4650 ...

INTRODUCTION AND OBJECTIVES The influence of coronary artery revascularization on the control of ventricular arrhythmias in patients with chronic myocardial infarction is uncertain. However, ablation of the arrhythmogenic circuit in these patients by aneurysm resection is useful for controlling ventricular arrhythmias. We made a prospective analysis of our clinical strategy in patients who were...

Current technology in robotic surgery allows us to perform myocardial revascularization procedures in a totally endoscopic fashion. We will describe the technique of choice for left internal mammary artery to left anterior descendent artery anastomosis with the use of cardiopulmonary bypass machine. The method is efficient and there is long term follow-up showing similar patency of the graft wh...