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ISSN 0188-2198 (Impreso)

2005, Número 2

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Rev Mex Cardiol 2005; 16 (2)


Prevalencia de viabilidad miocárdica en pacientes con cardiopatía isquémica y disfunción ventricular severa

Francisco Martínez Baca-López, Jorge Rayo-Chávez, Samuel Guízar-Flores, Óscar Orihuela-Rodríguez, Guillermo Galindo-Mendoza, Emma Rosas Munive

Idioma: Español
Referencias bibliográficas: 39
Paginas: 65-69
Archivo PDF: 102.58 Kb.


RESUMEN

Objetivo: Conocer la prevalencia de viabilidad miocárdica en pacientes con cardiopatía isquémica y disfunción ventricular severa. Material y métodos: Se estudiaron 55 pacientes con fracción de expulsión (FE) ≤ 35%. Se identificó viabilidad miocárdica mediante ecocardiog rama con dobutamina a dosis bajas. Resultados: 87% fueron hombres y 13% mujeres con rango de edad de 39-84 años. La prevalencia de viabilidad miocárdica fue 53%. Los pacientes fueron divididos en dos grupos: grupo I (GI) con viabilidad celular y grupo II (GII) sin viabilidad celular. Con relación a la localización del infarto, clase funcional (CF) y número de vasos enfermos no hubo diferencia estadística significativa, de los segmentos analizados en el GI predominó la hipocinesia ventricular 53% vs GII 30%, p: 0.0002002, OR: 1.83, IC 95% (1.31-2.55), en el GII la acinesia ventricular 36% vs GI 16%, p: 0.0000304, OR: 0.46, IC 95% (0.32-0.68). En cuanto al incremento de la excursión del endocardio en el GI 79% vs GII 45%, p: 0.0000655, OR: 1.81, IC 95% (1.34-2.46). Al comparar la función ventricular en reposo con la obtenida con estrés farmacológico tuvo significancia estadística el volumen sistólico final GI 114 mL vs GII 141 mL p: 0.006. La concordancia interobservador o Kappa fue de 0.69 y la intraobservador de 0.70. Conclusión: Los pacientes con cardiopatía isquémica y disfunción ventricular severa presentaron 53% de viabilidad miocárdica, este grupo de pacientes tiene probabilidades de recuperar su función ventricular mediante revascularización. La viabilidad celular se asoció a hipocinesia ventricular y excursión del endocardio > 5 mm predictores de recuperación de la función si el paciente es revascularizado.


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