Ischemic cardiomyopathy is a condition in which chronic myocardial ischemia leads to impaired cardiac function, left ventricular remodeling, and heart failure.
What it is
Ischemic cardiomyopathy develops when coronary artery disease, such as angina or myocardial infarction,
reduces blood supply to the myocardium. Over time, this results in impaired contractility,
left ventricular dilation, and progressive heart failure.
While historically more prevalent in Western countries, the number of affected patients is increasing in Japan.
Symptoms and diagnosis
Common symptoms include shortness of breath, reduced exercise tolerance, and other signs of heart failure.
Ventricular arrhythmias may also occur.
Diagnosis is based on echocardiography, cardiac CT, and assessment of coronary artery disease.
Our treatment approach
Treatment addresses both coronary artery disease and heart failure, with an individualized strategy based on myocardial viability and overall condition.
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Coronary revascularization:
Percutaneous intervention or coronary artery bypass surgery is performed to restore myocardial perfusion -
Heart failure management:
Guideline-directed medical therapy is used to reduce cardiac workload and stabilize function -
Mitral regurgitation:
Valve repair or replacement may be considered when regurgitation contributes to heart failure progression
Advanced surgical options such as left ventricular reconstruction or heart transplantation are considered selectively, based on expected benefit and patient condition.
Advanced therapy and risk management
In patients with ventricular arrhythmias or conduction disturbances,
device therapy such as implantable cardioverter-defibrillators (ICD)
or cardiac resynchronization therapy (CRT) may be indicated.
In advanced cases, the risk of sudden cardiac death is significant,
requiring careful monitoring and timely intervention.
Appointment
Appointments are required in principle. A referral letter from another medical institution is recommended but not mandatory.
For appointment requests and language support, please see the
Cardiovascular Center page.