Resumen

GONZALEZ MORENO, Juan Bautista et al. Reversible changes in left ventricular resting wall-motion contractile abnormalities with anti-ischemic drugs: An echocardiographic study. Rev.Urug.Cardiol. [online]. 2015, vol.30, n.2, pp.148-159. ISSN 1688-0420.

Objectives: to determine the clinical usefulness in detecting reversible resting echocardiographic segmental wall motion contractile abnormalities (ABC) in patients with stable coronary artery disease (CI). Background: There are no references in the literature. Population and method: This is a current clinical practice prospective observational study on 93 consecutive patients (58% men, median 69,7 years) with stress echocardiograms requested and showing non scarring ABC who were submitted to echocardiograms with nitrates and metoprolol instead. Left ventricular segmental wall motion score index (SS), electrocardiographic abnormalities (ECG) and chest pain changes were determined. Patients were referred either to direct catheterization (n=9), hospitalization (n=34) or to their residences (n=50). A 3,25-years-persons follow-up was performed. Results: SS, ECG abnormalities and chest pain changed significantly (p<0,001). The higher SS, the higher mortality. Global mortality was 6,34 p-mes^-1 x 1000; patients with medical vs. invasive treatment: 8,59 vs 3,8 p-mes^-1 x 1000, with direct catheterization vs. those hospitalized with deferred catheterization: 3,93 vs 7,22 p-mes^-1 x 1000, patients hospitalized without catheterization: 18,62 p-mes^-1 x 1000, and domiciliary patients with and without catheterization: 4,03 vs 4,05 p-mes^-1 x 1000. Patients with catheterization showed severe multi-vessel disease mainly. Conclusions: Reversible echocardiographic ABC with anti-ischemic drugs evokes resting myocardial ischemia, a high risk CI population and has important prognostic value.

Palabras clave : ECHOCARDIOGRAPHY; WALL MOTION CONTRACTILE ABNORMALITIES; NITRATES; METOPROLOL.

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