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Cardiac Magnetic Resonance Predictor of Ventricular Function after Surgical Coronary Revascularization.

Authors
  • Hwang, Ho Young1
  • Yeom, Sang Yoon2
  • Choi, Jae Woong1
  • Oh, Se Jin2
  • Park, Eun Ah3
  • Lee, Whal3
  • Kim, Ki Bong4
  • 1 Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea. , (North Korea)
  • 2 Department of Thoracic and Cardiovascular Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea. , (North Korea)
  • 3 Department of Radiology, Seoul National University Hospital, Seoul, Korea. , (North Korea)
  • 4 Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea. [email protected] , (North Korea)
Type
Published Article
Journal
Journal of Korean medical science
Publication Date
Dec 01, 2017
Volume
32
Issue
12
Pages
2009–2015
Identifiers
DOI: 10.3346/jkms.2017.32.12.2009
PMID: 29115084
Source
Medline
Keywords
License
Unknown

Abstract

We evaluated echocardiographic changes of left ventricular (LV) function in coronary artery bypass grafting (CABG) patients with LV dysfunction, and examined cardiac magnetic resonance (CMR) parameters associated with improved LV function. Seventy-seven CABG patients presenting with decreased LV ejection fraction (LVEF, ≤ 35%) and who underwent preoperative gadolinium-enhanced CMR were enrolled. A 16-segment model was used to analyze CMR imaging. A viable myocardial segment was defined as ≤ 50% transmural extent of late gadolinium enhancement. Serial echocardiographic examinations were performed preoperatively, pre-discharge (median 6 days), and during postoperative year 1 (median 11 months) in 70 patients. Predictors of absolute increase in LVEF (≥ 5%) and proportional changes in LVEF were analyzed. Serial echocardiography demonstrated that LVEF measured 28.6% ± 5.4% preoperatively, 31.5% ± 8.0% median 6 days, and 42.1% ± 10.5% median 11 months postoperatively. Absolute increase of LVEF was observed in 27 patients at pre-discharge and in 24 patients by median 11 months. Proportional changes in LVEF at postoperative median 6 days and 11 months were 14% ± 28% and 57% ± 45%, respectively. The median number of viable myocardial segments was 14 (range, 9-16) in the 16 segment CMR model. Multivariable models demonstrated that the median number of overall viable myocardial segments (≥ 14) in preoperative CMR was associated with absolute increase (P = 0.046) and proportional changes (P = 0.005) in LVEF. In conclusion, the number of viable myocardial segments (≥ 14) in preoperative CMR predicted LV function improvement after CABG in patients with LV dysfunction.

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