A clinical study of myocardial viability in predicting the improvement of cardiac function after coronary artery bypass grafting in patients with ischemic heart failure
- VernacularTitle:心肌活力预测缺血性心力衰竭患者冠状动脉旁路移植术后心功能改善的临床研究
- Author:
Dongdong WU
1
,
2
;
Zhigang LIU
1
,
2
;
Jianming LI
2
,
3
;
Guoliang FAN
2
,
4
;
Tong DING
5
,
6
;
Xiaocheng LIU
1
,
2
Author Information
1. Department of Cardiac Surgery, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences &
2. Peking Union Medical College, Tianjin, 300457, P.R.China
3. Department of Nuclear Medicine, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences &
4. Intensive Care Unit, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences &
5. Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences &
6. Peking Union Medical College, Beijing, 100037, P.R.China
- Publication Type:Journal Article
- Keywords:
Ischemic heart failure;
coronary artery bypass grafting (CABG);
myocardial viability;
prognosis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2020;27(11):1314-1319
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the predictive value of myocardial vitality in the improvement of cardiac function after coronary artery bypass grafting (CABG) in patients with ischemic heart failure. Methods From December 8, 2015 to November 12, 2018, 46 patients with ischemic heart failure who underwent CABG operation alone were collected retrospectively. There were 41 males and 5 females with an average age of 60.4±8.0 years. The myocardial vitality and number of different types of myocardium were measured. The clinical data of patients in the left ventricular ejection fraction (LVEF) improvement group (≥5%) and non-improvement group (<5%) were compared and analyzed. The correlation between each index and LVEF improvement was analyzed by logistic multivariate regression analysis, and the boundary value of hibernating myocardium between LVEF improvement and non-improvement was obtained by receiver operating characteristic (ROC) curve. Results There were significant differences in the number of hibernating myocardium (15.0%±12.3% vs. 4.3%±4.5%, P=0.000), the number of normal myocardium (74.7%±13.7% vs. 82.4%±8.6%, P=0.027), and cardiac function classification (NYHA) development (−0.7±0.7 vs. −0.3±0.5, P=0.047) between the two groups, but there was no significant difference in other indexes between the two groups (P>0.05). Logistic regression analysis showed that the number of hibernating myocardium was an independent factor affecting the improvement of LVEF after CABG in patients with ischemic heart failure (OR=1.366, 95%CI 1.033-1.807, P=0.029). The ROC curve showed that the threshold value, sensitivity and specificity of hibernating myocardium were 15.0%, 43.8% and 100.0%, respectively. Conclusion The percentage of hibernating myocardium to left ventricular wall area ≥15.0% can accurately predict the improvement of LVEF in patients with ischemic heart failure after CABG. Preoperative myocardial vitality assessment has important diagnostic value in predicting the improvement of cardiac function in patients with ischemic heart failure after simple CABG.
