• Jaroslav Meluzín, Jan Cerný, Lenka Spinarová, Jirí Toman, Ladislav Groch, Frantisek Stetka, Milan Frélich, Petr Hude, Jan Krejcí, Lada Rambousková, and Roman Panovský.
• First Department of Internal Medicine, Masaryk University, St. Anna Hospital, Pekarská 53, Brno, Czech Republic.
• Eur. J. Heart Fail. 2003 Jan 1;5(1):85-93.

Background And AimThe choice of optimal treatment strategy in patients with coronary artery disease (CAD) and severe left ventricular (LV) dysfunction is often difficult. The aim of this study was to compare long-term results of patients with chronic CAD, severe heart failure and a defined scope of myocardial viability treated with coronary revascularization, heart transplantation, or kept on medical therapy.MethodsFrom 1993 to 2000, viability evaluation using low-dose dobutamine echocardiography was performed in 124 patients with CAD and LV ejection fraction ResultsThe Kaplan-Meier survival analysis demonstrated a significantly better survival of group A patients as compared with group B patients (P<0.05). The prognostic benefit of revascularization in patients with viability was not manifested until 3 years after the procedure. At 5 years, survival in groups A, B, C, D and E was 89, 60, 67, 50 and 78%, respectively.ConclusionIn patients with CAD, severe LV dysfunction, and the evidence of viability in dysfunctional myocardium, coronary revascularization improves survival. At least 3-years follow-up is necessary to objectively assess the prognostic effect of coronary revascularization.

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