Analysis of related factors of poor recovery of left ventricular ejection function after ischemic cardiomyopathy CABG
10.3760/cma.j.cn431274-20191106-01293
- VernacularTitle:缺血性心肌病CABG术后左心室射血功能恢复不良的相关因素分析
- Author:
Zhanfa SUN
1
;
Rong LIU
;
Yuan ZHANG
Author Information
1. 青岛市市立医院心脏外科 266011
- From:
Journal of Chinese Physician
2020;22(11):1695-1698,1702
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the benefit of left ventricular ejection function and its influencing factors in patients with ischemic cardiomyopathy undergoing coronary artery bypass grafting (CABG) after revascularization.Methods:A retrospective analysis was performed on 226 patients with ischemic cardiomyopathy who underwent CABG and a preoperative left ventricular ejection fraction (LVEF) between 30% and 40% in Qingdao Municipal Hospital from March 2015 to March 2019. During the follow-up to 6 months after surgery, the recovery of LVEF was observed. The increase of LVEF was ≥10% in the recovery group, and the increase in LVEF was <10% in the recovery group. The clinical, laboratory, and echocardiographic factors that may cause differences were analyzed.Results:Of the 226 patients, 121(53.5%) had good left ventricular function recovery. Univariate analysis showed that the recovery of LVEF in patients with ischemic cardiomyopathy (30% ≤LVEF≤40%) was related to myocardial infarction, preoperative angina pectoris attack, N-terminal pro-B-type natriuretie peptide (NT-proBNP) level, left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD) and left ventricular end diastolic volume (LVEDV). Multivariate analysis showed that increased LVEDD and non-angina pectoris were independent risk factors for poor LVEF recovery in patients with ischemic cardiomyopathy (30%≤LVEF≤40%) ( OR=3.898, 1.214, P<0.05). LVEDD≥60 mm was significantly associated with poor recovery (χ 2=8.631, OR=2.214, 95% CI=1.252-3.981, P=0.005). The sensitivity and specificity of LVEDD≥60 mm in predicting postoperative poor LVEF recovery in patients with ischemic cardiomyopathy (30%≤LVEF≤ 40%) were 74.6% and 47.5%, respectively. Conclusions:The increased LVEDD and no angina pectoris were independent risk factors for poor LVEF recovery after CABG in patients with ischemic cardiomyopathy (30%≤LVEF≤40%). LVEDD≥60 mm can be used as a predictor of less benefit from preoperative ejection function.
