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.

Objective    To explore the relationship between obstructive sleep apnea-hypopnea syndrome (OSAHS) and aortic dissection (AD). Methods    Fifty three patients with AD diagnosed by CTA in our hospital from January 2016 to January 2018 were selected. All the patients with AD were scored by the STOP-BANG questionnaire. The patients who scored more than or equal to 3 received polysomnography (PSG) after surgical or conservative treatment, and according to whether the sleep apnea-hypopnea index was higher than or equal to 5. Fifty-three patients were divided into an OSAHS group and a non OSAHS group. Results    There were 18 patients with 17 males and 1 female at average age of 43.3±8.4 years in the OSAHS group, and 35 patients with 23 males and 12 females at average age of 56.6±12.9 years in the non OSAHS group. There was no statistical difference between the two groups in the Stanford classification of aortic dissection, the time of onset, personal history, the history of diabetes, coronary heart disease and hyperlipidemia, or post-treatment systolic/diastolic blood pressure before sleep (P>0.05). The age of patients in the OSAHS group was significantly less than that in the non OSAHS group (P<0.01), the proportion of men/women (P=0.021), weight (P<0.01), height (P=0.028), body mass index (P<0.01), and post-treatment systolic/diastolic blood pressure after waking up (P=0.028,P=0.044) in the OSAHS group were significantly higher than those in the non OSAHS group. In the OSAHS group, the proportion of previous hypertension was significantly higher than that in the non OSAHS group (P=0.042).   Conclusion    AD patients combined with OSAHS are mostly male patients. The number of young and high-fat people is significantly more than that in the non OSAHS group. OSAHS may be one of the risk factors for young, high-fat men with AD.