Viabilidad miocárdica en pacientes con cardiopatía isquémica a través de resonancia magnética cardiaca

La cardiopatía isquémica es una condición patológica caracterizada por la reducción del flujo sanguíneo que causa un desequilibrio entre la suplencia y la demanda de oxígeno. El concepto de “viabilidad miocárdica” surge de la observación de desdiferenciación celular con pérdida de las proteínas cont...

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Fecha de publicación:: 2023

Institución:: Universidad del Rosario

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dc.title.none.fl_str_mv	Viabilidad miocárdica en pacientes con cardiopatía isquémica a través de resonancia magnética cardiaca
dc.title.TranslatedTitle.none.fl_str_mv	Myocardial viability in patients with ischemic heart disease by cardiac magnetic resonance imaging
title	Viabilidad miocárdica en pacientes con cardiopatía isquémica a través de resonancia magnética cardiaca
spellingShingle	Viabilidad miocárdica en pacientes con cardiopatía isquémica a través de resonancia magnética cardiaca Viabilidad miocárdica Resonancia cardiaca Disfunción ventricular Arteriografía coronaria Revascularización miocárdica Cardiomiopatía isquémica Myocardial viability Cardiac resonance Left ventricular dysfunction Myocardial Revascularization Coronary Artery Arteriography Ischemic Cardiomyopathy
title_short	Viabilidad miocárdica en pacientes con cardiopatía isquémica a través de resonancia magnética cardiaca
title_full	Viabilidad miocárdica en pacientes con cardiopatía isquémica a través de resonancia magnética cardiaca
title_fullStr	Viabilidad miocárdica en pacientes con cardiopatía isquémica a través de resonancia magnética cardiaca
title_full_unstemmed	Viabilidad miocárdica en pacientes con cardiopatía isquémica a través de resonancia magnética cardiaca
title_sort	Viabilidad miocárdica en pacientes con cardiopatía isquémica a través de resonancia magnética cardiaca
dc.contributor.advisor.none.fl_str_mv	Lugo Peña, Julián Rodrigo Campo Bautista, Esther María
dc.subject.none.fl_str_mv	Viabilidad miocárdica Resonancia cardiaca Disfunción ventricular Arteriografía coronaria Revascularización miocárdica Cardiomiopatía isquémica
topic	Viabilidad miocárdica Resonancia cardiaca Disfunción ventricular Arteriografía coronaria Revascularización miocárdica Cardiomiopatía isquémica Myocardial viability Cardiac resonance Left ventricular dysfunction Myocardial Revascularization Coronary Artery Arteriography Ischemic Cardiomyopathy
dc.subject.keyword.none.fl_str_mv	Myocardial viability Cardiac resonance Left ventricular dysfunction Myocardial Revascularization Coronary Artery Arteriography Ischemic Cardiomyopathy
description	La cardiopatía isquémica es una condición patológica caracterizada por la reducción del flujo sanguíneo que causa un desequilibrio entre la suplencia y la demanda de oxígeno. El concepto de “viabilidad miocárdica” surge de la observación de desdiferenciación celular con pérdida de las proteínas contráctiles pero sin muerte celular (sin necrosis), el cual es un estado protector con una baja tasa metabólica como respuesta a la poca oferta de oxígeno y nutrientes. Se ha observado que al restablecer el flujo a estos territorios coronarios, hay recuperación de la función contráctil, parcial o completamente. Esta recuperación del miocardio viable ha despertado el interés ya que podría llevar a una mejoría en la función cardiaca y así, a una mejoría en sobrevida. Las imágenes de viabilidad tienen una significancia clínica importante para la identificación de este miocardio que tiene un potencial para la restauración de la función. Publicaciones recientes han demostrado la precisión de la resonancia magnética cardíaca con realce con Gadolinium en la evaluación de la viabilidad miocárdica; sin embargo, no se ha demostrado el beneficio en supervivencia de la revascularización guiada por la viabilidad miocárdica, por lo que se llevó a cabo este estudio. Encontramos que la incidencia de eventos cardiovasculares mayores fue menor en el grupo de intervención, sin mejoría significativa en la angina, clase funcional ni en la FEVI. Sin embargo, la presencia o no de viabilidad miocárdica no modificó la incidencia de desenlaces cardiovasculares ni el comportamiento de la función sistólica.
publishDate	2023
dc.date.created.none.fl_str_mv	2023-05-25
dc.date.accessioned.none.fl_str_mv	2024-03-01T16:18:55Z
dc.date.available.none.fl_str_mv	2024-03-01T16:18:55Z
dc.type.none.fl_str_mv	article
dc.type.coar.fl_str_mv	http://purl.org/coar/resource_type/c_6501
dc.type.document.none.fl_str_mv	Trabajo de grado
dc.type.spa.none.fl_str_mv	Artículo
dc.identifier.uri.none.fl_str_mv	https://repository.urosario.edu.co/handle/10336/42309
url	https://repository.urosario.edu.co/handle/10336/42309
dc.language.iso.none.fl_str_mv	spa
language	spa
dc.rights.*.fl_str_mv	Attribution-NonCommercial-ShareAlike 4.0 International
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dc.rights.acceso.none.fl_str_mv	Abierto (Texto Completo)
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rights_invalid_str_mv	Attribution-NonCommercial-ShareAlike 4.0 International Abierto (Texto Completo) http://creativecommons.org/licenses/by-nc-sa/4.0/ http://purl.org/coar/access_right/c_abf2
dc.format.extent.none.fl_str_mv	87 pp
dc.format.mimetype.none.fl_str_mv	application/pdf
dc.publisher.none.fl_str_mv	Universidad del Rosario
dc.publisher.department.none.fl_str_mv	Escuela de Medicina y Ciencias de la Salud
dc.publisher.program.none.fl_str_mv	Especialización en Cardiología
publisher.none.fl_str_mv	Universidad del Rosario
institution	Universidad del Rosario
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CMR Imaging Assessing Viability in Patients With Chronic Ventricular Dysfunction Due to Coronary Artery Disease: A Meta-Analysis of Prospective Trials. JACC Cardiovasc Imaging [Internet]. 2012;5(5):494–508. Available from: https://www.sciencedirect.com/science/article/pii/S1936878X12002756 Mc Ardle B, Shukla T, Nichol G, Dekemp RA, Bernick J, Guo A, et al. Long-Term Follow-Up of Outcomes with F-18-Fluorodeoxyglucose Positron Emission Tomography Imaging-Assisted Management of Patients with Severe Left Ventricular Dysfunction Secondary to Coronary Disease. Circ Cardiovasc Imaging. 2016 Sep 1;9(9). de Bruyne B, Pijls NHJ, Kalesan B, Barbato E, Tonino PAL, Piroth Z, et al. Fractional Flow Reserve–Guided PCI versus Medical Therapy in Stable Coronary Disease. New England Journal of Medicine. 2012 Sep 13;367(11):991–1001. Selvanayagam JB, Kardos A, Francis JM, Wiesmann F, Petersen SE, Taggart DP, et al. Value of Delayed-Enhancement Cardiovascular Magnetic Resonance Imaging in Predicting Myocardial Viability After Surgical Revascularization. Circulation. 2004 Sep 21;110(12):1535–41. Pegg TJ, Selvanayagam JB, Jennifer J, Francis JM, Karamitsos TD, Dall’Armellina E, et al. Prediction of global left ventricular functional recovery in patients with heart failure undergoing surgical revascularisation, based on late gadolinium enhancement Cardiovascular Magnetic Resonance. Journal of Cardiovascular Magnetic Resonance. 2010 Dec 7;12(1):56. Gerber BL, Darchis J, le Polain de Waroux JB, Legros G, Pouleur AC, Vancraeynest D, et al. Relationship Between Transmural Extent of Necrosis and Quantitative Recovery of Regional Strains After Revascularization. JACC Cardiovasc Imaging. 2010 Jul;3(7):720–30. Choi KM, Kim RJ, Gubernikoff G, Vargas JD, Parker M, Judd RM. Transmural Extent of Acute Myocardial Infarction Predicts Long-Term Improvement in Contractile Function. Circulation. 2001 Sep 4;104(10):1101–7. Chen Z, Sohal M, Sammut E, Child N, Jackson T, Claridge S, et al. Focal But Not Diffuse Myocardial Fibrosis Burden Quantification Using Cardiac Magnetic Resonance Imaging Predicts Left Ventricular Reverse Modeling Following Cardiac Resynchronization Therapy. J Cardiovasc Electrophysiol. 2016 Feb;27(2):203–9. Löffler AI, Kramer CM. Myocardial Viability Testing to Guide Coronary Revascularization. Interv Cardiol Clin. 2018 Jul;7(3):355–65. Neumann FJ, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. Vol. 40, European Heart Journal. Oxford University Press; 2019. p. 87–165. Wijns W, Vatner SF, Camici PG. Hibernating Myocardium. New England Journal of Medicine. 1998 Jul 16;339(3):173–81. Jensen RV, Hjortbak MV, Bøtker HE. Ischemic Heart Disease: An Update. Semin Nucl Med. 2020 May;50(3):195–207. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet. 2012 Dec;380(9859):2095–128. Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, et al. Heart Disease and Stroke Statistics—2021 Update. Circulation. 2021 Feb 23;143(8). Kolwicz SC, Purohit S, Tian R. Cardiac Metabolism and its Interactions With Contraction, Growth, and Survival of Cardiomyocytes. Circ Res. 2013 Aug 16;113(5):603–16. Slart RHJA, Bax JJ, van der Wall EE, van Veldhuisen DJ, Jager PL, Dierckx RA. Nuclear cardiac imaging for the assessment of myocardial viability. Neth Heart J. 2005 Nov;13(11):408–15. Dilsizian V, Rocco TP, Freedman NMT, Leon MB, Bonow RO. Enhanced Detection of Ischemic but Viable Myocardium by the Reinjection of Thallium after Stress-Redistribution Imaging. New England Journal of Medicine. 1990 Jul 19;323(3):141–6. Schulz-Menger J, Bluemke DA, Bremerich J, Flamm SD, Fogel MA, Friedrich MG, et al. Standardized image interpretation and post-processing in cardiovascular magnetic resonance - 2020 update. Journal of Cardiovascular Magnetic Resonance. 2020 Dec 12;22(1):19. Beanlands RSB, Nichol G, Huszti E, Humen D, Racine N, Freeman M, et al. F-18-Fluorodeoxyglucose Positron Emission Tomography Imaging-Assisted Management of Patients With Severe Left Ventricular Dysfunction and Suspected Coronary Disease. A Randomized, Controlled Trial (PARR-2). J Am Coll Cardiol. 2007 Nov 13;50(20):2002–12. Kim RJ, Fieno DS, Parrish TB, Harris K, Chen EL, Simonetti O, et al. Relationship of MRI Delayed Contrast Enhancement to Irreversible Injury, Infarct Age, and Contractile Function. Circulation. 1999 Nov 9;100(19):1992–2002. Bax JJ, Poldermans D, Elhendy A, Boersma E, Rahimtoola SH. Sensitivity, specificity, and predictive accuracies of various noninvasive techniques for detecting hibernating myocardium. Curr Probl Cardiol. 2001 Feb;26(2):147–81. McDiarmid AK, Pellicori P, Cleland JG, Plein S. Taxonomy of segmental myocardial systolic dysfunction. Eur Heart J. 2016 May 4;ehw140. Gunning MG, Kaprielian RR, Pepper J, Pennell DJ, Sheppard MN, Severs NJ, et al. The histology of viable and hibernating myocardium in relation to imaging characteristics. J Am Coll Cardiol. 2002 Feb;39(3):428–35. Larose E, Rodés-Cabau J, Pibarot P, Rinfret S, Proulx G, Nguyen CM, et al. Predicting Late Myocardial Recovery and Outcomes in the Early Hours of ST-Segment Elevation Myocardial Infarction. J Am Coll Cardiol. 2010 Jun;55(22):2459–69. Gerber BL, Rousseau MF, Ahn SA, le Polain de Waroux JB, Pouleur AC, Phlips T, et al. Prognostic Value of Myocardial Viability by Delayed-Enhanced Magnetic Resonance in Patients With Coronary Artery Disease and Low Ejection Fraction. J Am Coll Cardiol. 2012 Feb;59(9):825–35. Garcia MJ, Kwong RY, Scherrer-Crosbie M, Taub CC, Blankstein R, Lima J, et al. State of the Art: Imaging for Myocardial Viability: A Scientific Statement from the American Heart Association. Circ Cardiovasc Imaging. 2020 Jul 1;13(7). Panza JA, Chrzanowski L, Bonow RO. Myocardial Viability Assessment Before Surgical Revascularization in Ischemic Cardiomyopathy. J Am Coll Cardiol. 2021 Sep;78(10):1068–77. Bozkurt B, Coats AJ, Tsutsui H, Abdelhamid M, Adamopoulos S, Albert N, et al. Universal Definition and Classification of Heart Failure. J Card Fail. 2021 Apr;27(4):387–413. Collet JP, Thiele H, Barbato E, Barthélémy O, Bauersachs J, Bhatt DL, et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2021 Apr 7;42(14):1289–367. Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2018 Jan 7;39(2):119–77. Ad N, Holmes SD, Patel J, Pritchard G, Shuman DJ, Halpin L. Comparison of EuroSCORE II, Original EuroSCORE, and The Society of Thoracic Surgeons Risk Score in Cardiac Surgery Patients. Ann Thorac Surg. 2016 Aug;102(2):573–9. Kwon DH, Obuchowski NA, Marwick TH, Menon V, Griffin B, Flamm SD, et al. Jeopardized Myocardium Defined by Late Gadolinium Enhancement Magnetic Resonance Imaging Predicts Survival in Patients With Ischemic Cardiomyopathy: Impact of Revascularization. J Am Heart Assoc. 2018 Nov 20;7(22). Kwon DH, Hachamovitch R, Popovic ZB, Starling RC, Desai MY, Flamm SD, et al. Survival in Patients With Severe Ischemic Cardiomyopathy Undergoing Revascularization Versus Medical Therapy. Circulation. 2012 Sep 11;126(11_suppl_1). Orlandini A, Castellana N, Pascual A, Botto F, Cecilia Bahit M, Chacon C, et al. Myocardial viability for decision-making concerning revascularization in patients with left ventricular dysfunction and coronary artery disease: A meta-analysis of non-randomized and randomized studies. Int J Cardiol. 2015 Mar;182:494–9. Beanlands RSB, Ruddy TD, deKemp RA, Iwanochko RM, Coates G, Freeman M, et al. Positron emission tomography and recovery following revascularization (PARR-1): the importance of scar and the development of a prediction rule for the degree of recovery of left ventricular function. J Am Coll Cardiol. 2002 Nov;40(10):1735–43. Velazquez EJ, Lee KL, Deja MA, Jain A, Sopko G, Marchenko A, et al. Coronary-Artery Bypass Surgery in Patients with Left Ventricular Dysfunction. New England Journal of Medicine. 2011 Apr 28;364(17):1607–16. Velazquez EJ, Lee KL, Jones RH, Al-Khalidi HR, Hill JA, Panza JA, et al. Coronary-Artery Bypass Surgery in Patients with Ischemic Cardiomyopathy. New England Journal of Medicine. 2016 Apr 21;374(16):1511–20. Abraham A, Nichol G, Williams KA, Guo A, deKemp RA, Garrard L, et al. 18F-FDG PET Imaging of Myocardial Viability in an Experienced Center with Access to 18F-FDG and Integration with Clinical Management Teams: The Ottawa-FIVE Substudy of the PARR 2 Trial. Journal of Nuclear Medicine. 2010 Apr;51(4):567–74. Shah DJ, Kim HW, James O, Parker M, Wu E, Bonow RO, et al. Prevalence of Regional Myocardial Thinning and Relationship With Myocardial Scarring in Patients With Coronary Artery Disease. JAMA. 2013 Mar 6;309(9):909. Cerqueira MD, Weissman NJ, Dilsizian V, Jacobs AK, Kaul S, Laskey WK, et al. Standardized Myocardial Segmentation and Nomenclature for Tomographic Imaging of the Heart. Circulation. 2002 Jan 29;105(4):539–42. Schoenfeld DA. Sample-Size Formula for the Proportional-Hazards Regression Model. Biometrics. 1983 Jun;39(2):499. Hernández CE, Carpio N. Introducción a los tipos de muestreo. ALERTA Revista Científica del Instituto Nacional de Salud. 2019 Mar 13;2(1):75–9. Marsaglia G, Tsang WW, Wang J. Evaluating Kolmogorov’s Distribution. J Stat Softw. 2003;8(18). McHugh ML. The Chi-square test of independence. Biochem Med (Zagreb). 2013;143–9. Paul P, Pennell ML, Lemeshow S. Standardizing the power of the Hosmer-Lemeshow goodness of fit test in large data sets. Stat Med. 2013 Jan 15;32(1):67–80. Williams JR. Revising the declaration of Helsinki. World Med J. 2008;54(4):120–2. Ministerio de Salud. Resolución 8430 de 1993 [Internet]. Colombia; 1993 [cited 2022 Apr 15]. p. 1–19. Available from: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/DIJ/RESOLUCION-8430-DE-1993.PDF Kwon DH, Halley CM, Carrigan TP, Zysek V, Popovic ZB, Setser R, et al. Extent of Left Ventricular Scar Predicts Outcomes in Ischemic Cardiomyopathy Patients With Significantly Reduced Systolic Function. JACC Cardiovasc Imaging. 2009 Jan;2(1):34–44. Perera D, Clayton T, O’Kane PD, Greenwood JP, Weerackody R, Ryan M, et al. 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spelling	Lugo Peña, Julián Rodrigoa489990a-e56c-422e-8938-6255515636cd-1Campo Bautista, Esther María99cda2e4-f464-416e-b0a9-6b55b5fb4b52-1Zuluaga Monroy, Juan DavidBarragán Amado, Andrés FelipeEspecialista en CardiologíaMaestríaFull time84180430-e275-4647-891a-892d188a224b-16657587f-d195-4e62-95a5-f85ecd9c34b3-12024-03-01T16:18:55Z2024-03-01T16:18:55Z2023-05-25La cardiopatía isquémica es una condición patológica caracterizada por la reducción del flujo sanguíneo que causa un desequilibrio entre la suplencia y la demanda de oxígeno. El concepto de “viabilidad miocárdica” surge de la observación de desdiferenciación celular con pérdida de las proteínas contráctiles pero sin muerte celular (sin necrosis), el cual es un estado protector con una baja tasa metabólica como respuesta a la poca oferta de oxígeno y nutrientes. Se ha observado que al restablecer el flujo a estos territorios coronarios, hay recuperación de la función contráctil, parcial o completamente. Esta recuperación del miocardio viable ha despertado el interés ya que podría llevar a una mejoría en la función cardiaca y así, a una mejoría en sobrevida. Las imágenes de viabilidad tienen una significancia clínica importante para la identificación de este miocardio que tiene un potencial para la restauración de la función. Publicaciones recientes han demostrado la precisión de la resonancia magnética cardíaca con realce con Gadolinium en la evaluación de la viabilidad miocárdica; sin embargo, no se ha demostrado el beneficio en supervivencia de la revascularización guiada por la viabilidad miocárdica, por lo que se llevó a cabo este estudio. Encontramos que la incidencia de eventos cardiovasculares mayores fue menor en el grupo de intervención, sin mejoría significativa en la angina, clase funcional ni en la FEVI. Sin embargo, la presencia o no de viabilidad miocárdica no modificó la incidencia de desenlaces cardiovasculares ni el comportamiento de la función sistólica.Ischemic heart disease is a pathological condition characterized by reduced blood flow that causes an imbalance between oxygen supply and demand. The concept of "myocardial viability" arises from the observation of cell dedifferentiation with loss of contractile proteins but without cell death (without necrosis), which is a protective state with a low metabolic rate in response to the low supply of oxygen and nutrients. It has been observed that by restoring the flow to these coronary territories, there is recovery of the contractile function, partially or completely. This recovery of viable myocardium has aroused interest as it could lead to improved cardiac function and thus improved survival. Viability imaging has important clinical significance for the identification of this myocardium that has potential for restoration of function. Recent publications have demonstrated the accuracy of Gadolinium-enhanced cardiac MRI in assessing myocardial viability; however, the survival benefit of myocardial viability-guided revascularization has not been demonstrated, which is why we carried out this study. We found that the incidence of major cardiovascular events was lower in the intervention group, with no significant improvement in angina, functional class, or LVEF. However, the presence or absence of myocardial viability did not modify the incidence of cardiovascular outcomes or the behavior of systolic function.87 ppapplication/pdfhttps://repository.urosario.edu.co/handle/10336/42309spaUniversidad del RosarioEscuela de Medicina y Ciencias de la SaludEspecialización en CardiologíaAttribution-NonCommercial-ShareAlike 4.0 InternationalAbierto (Texto Completo)EL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma. PARGRAFO: En caso de presentarse cualquier reclamación o acción por parte de un tercero en cuanto a los derechos de autor sobre la obra en cuestión, EL AUTOR, asumirá toda la responsabilidad, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos la universidad actúa como un tercero de buena fe. EL AUTOR, autoriza a LA UNIVERSIDAD DEL ROSARIO, para que en los términos establecidos en la Ley 23 de 1982, Ley 44 de 1993, Decisión andina 351 de 1993, Decreto 460 de 1995 y demás normas generales sobre la materia, utilice y use la obra objeto de la presente autorización. -------------------------------------- POLITICA DE TRATAMIENTO DE DATOS PERSONALES. Declaro que autorizo previa y de forma informada el tratamiento de mis datos personales por parte de LA UNIVERSIDAD DEL ROSARIO para fines académicos y en aplicación de convenios con terceros o servicios conexos con actividades propias de la academia, con estricto cumplimiento de los principios de ley. Para el correcto ejercicio de mi derecho de habeas data cuento con la cuenta de correo habeasdata@urosario.edu.co, donde previa identificación podré solicitar la consulta, corrección y supresión de mis datos.http://creativecommons.org/licenses/by-nc-sa/4.0/http://purl.org/coar/access_right/c_abf2Felker GM, Shaw LK, O’Connor CM. 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Viabilidad miocárdica en pacientes con cardiopatía isquémica a través de resonancia magnética cardiaca

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