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

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dc.contributor.advisorLugo Peña, Julián Rodrigo
dc.contributor.advisorCampo Bautista, Esther María
dc.creatorZuluaga Monroy, Juan David
dc.creatorBarragán Amado, Andrés Felipe
dc.creator.degreeEspecialista en Cardiología
dc.creator.degreeLevelMaestría
dc.creator.degreetypeFull time
dc.date.accessioned2024-03-01T16:18:55Z
dc.date.available2024-03-01T16:18:55Z
dc.date.created2023-05-25
dc.descriptionLa 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.
dc.description.abstractIschemic 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.
dc.format.extent87 pp
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dc.identifier.doihttps://doi.org/10.48713/10336_42309
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/42309
dc.language.isospa
dc.publisherUniversidad del Rosario
dc.publisher.departmentEscuela de Medicina y Ciencias de la Salud
dc.publisher.programEspecialización en Cardiología
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dc.source.instnameinstname:Universidad del Rosario
dc.source.reponamereponame:Repositorio Institucional EdocUR
dc.subjectViabilidad miocárdica
dc.subjectResonancia cardiaca
dc.subjectDisfunción ventricular
dc.subjectArteriografía coronaria
dc.subjectRevascularización miocárdica
dc.subjectCardiomiopatía isquémica
dc.subject.keywordMyocardial viability
dc.subject.keywordCardiac resonance
dc.subject.keywordLeft ventricular dysfunction
dc.subject.keywordMyocardial Revascularization
dc.subject.keywordCoronary Artery Arteriography
dc.subject.keywordIschemic Cardiomyopathy
dc.titleViabilidad miocárdica en pacientes con cardiopatía isquémica a través de resonancia magnética cardiaca
dc.title.TranslatedTitleMyocardial viability in patients with ischemic heart disease by cardiac magnetic resonance imaging
dc.typearticle
dc.type.documentTrabajo de grado
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.type.spaArtículo
local.department.reportEscuela de Medicina y Ciencias de la Salud
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