Persistent Ventricular Asynchrony after Coronary Artery Bypass Surgery Predicts Cardiac Events
2010 (English)In: Echocardiography, ISSN 0742-2822, E-ISSN 1540-8175, Vol. 27, no 1, 32-37 p.Article in journal (Refereed) Published
Aim: The aim of this study was to identify echocardiographic LV systolic and diastolic measurements that predict clinical events post-coronary artery bypass graft (CABG) surgery. Methods: We collected data from 27 patients (age 70 +/- 7 years) who underwent elective CABG, before and within 6 weeks after surgery. LV systolic function was assessed by conventional echocardiographic parameters. A number of LV filling measurements were also made, which included total isovolumic time (t-IVT), Tei index, and restrictive filling pattern. Postoperative cardiac events were death or hospitalization for chest pain, breathlessness, or arrhythmia. Results: Patient's follow-up period was 17 +/- 10 months. Of the 27 patients (age 70 +/- 7 years, 22 male), 10 had postoperative cardiac events. LV ejection fraction (EF) and fractional shortening (FS) were lower (P = 0.01, and P = 0.007, respectively), t-IVT longer (P < 0.001), and Tei index was higher (P < 0.001) preoperatively in patients with events compared to those without. The same differences between groups remained after surgery; EF (P = 0.002), FS (P = 0.002), t-IVT (P < 0.001), and Tei index (P < 0.001). T-IVT was the only preoperative predictor of events (P = 0.038) but its postoperative value as well as that of FS predicted events (P = 0.034, and P = 0.042, respectively). T-IVT of 12.2 s/min and FS of 26% were 80% sensitive and 88% specific for predicting postoperative events. Conclusion: Despite successful surgical revascularization residual impairment of LV systolic function and persistent asynchrony in the form of prolonged t-IVT are associated with postoperative events. Since these abnormalities remained despite full medical therapy, they may thus suggest a need for electrical resynchronization therapy.
Place, publisher, year, edition, pages
2010. Vol. 27, no 1, 32-37 p.
coronary artery bypass grafting, Doppler echocardiography, LV asynchrony, total isovolumic time
Cardiac and Cardiovascular Systems
IdentifiersURN: urn:nbn:se:umu:diva-32919DOI: 10.1111/j.1540-8175.2009.00981.xISI: 000274388600006PubMedID: 19765065OAI: oai:DiVA.org:umu-32919DiVA: diva2:306752