Survival benefit after revascularization is independent of left ventricular ejection fraction improvement in patients with previous myocardial infarction and viable myocardium

Methods: We studied 253 patients with previous myocardial infarction and evidence of dysfunctional viable myocardium as assessed by echocardiography and Tc-99m-sestamibi imaging. Coronary revascularization was performed in 142 patients, while 111 were medically treated. In revascularized patients, echocardiography was repeated 12 months later to detect LV ejection fraction improvement, defined as an increase of >= 5% compared with baseline. All patients were followed for a mean period of 52 +/- 29 months. Cardiac death and non-fatal myocardial infarction were considered as events.

Purpose: This study was designed to assess the relationships among myocardial viability, changes in left ventricular (LV) ejection fraction after coronary revascularization and long-term event-free survival in patients with previous myocardial infarction and LV dysfunction.