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Prevalence of regional and whole-heart viability in patients with myocardial akinesis consecutively enrolled from 4 US hospitals
© Labib et al. 2016
Published: 27 January 2016
The efficacy of current and novel heart failure therapies is likely related to viability that denotes the presence of cardiac reserve. Previous studies assessed viability mostly on a segmental rather than patient level, and included hypokinetic segments, which by definition−given residual contractile function−are viable. Additionally, studies have suggested that long-term survival is affected by the presence of viability in akinetic, not hypokinetic, segments. Therefore, we aimed to assess viability among patients with myocardial akinesis referred for cardiovascular MRI (CMR).
Data analysis was performed on a cloud-based system that is currently receiving de-identified searchable data from reports with full DICOM datasets for 23,275 consecutive CMR exams performed at 4 U.S. hospitals from 2010-2014. At the time of abstract submission, 8,242 CMR datasets have been analyzed, and analysis of all 23,275 is expected by the end of 2015. All data fields were derived from reports that had been electronically signed by board-certified physicians with Level 3 CMR training. Each dataset included scores for wall motion and hyperenhancement (HE) on a standard 17 segments AHA model. We included only patients having one or more akinetic segments, defined as having no visible systolic increase in wall thickness. Patients with dyskinetic segments−showing systolic wall thinning−were also included. Segment viability was defined as HE less than 50% transmural, and "whole-heart" viability was defined as present if all 17 segments were deemed viable.
Characteristics in Patients with Myocardial Akinesis (n = 725)
Age (mean ± SD)
56 ± 18 years
Family history of CAD
LV ejection fraction (mean ± SD)
35.1% ± 13.5%
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