Comparison of cardiovascular magnetic resonance of late gadolinium enhancement and diastolic wall thickness to predict recovery of left ventricular function after coronary artery bypass surgery

• Published in: Journal of cardiovascular magnetic resonance Vol. 10; no. 1; p. 41
• Main Authors: Krittayaphong, Rungroj, Laksanabunsong, Pansak, Maneesai, Adisak, Saiviroonporn, Pairash, Udompunturak, Suthipol, Chaithiraphan, Vithaya
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 22.09.2008; BioMed Central; Elsevier
• Subjects: Adult; Aged; Cardiovascular diseases; Care and treatment; Comparative analysis; Contrast Media; Coronary Artery Bypass; Coronary Artery Disease - pathology; Coronary Artery Disease - physiopathology; Coronary Artery Disease - surgery; Female; Gadolinium; Gadolinium DTPA; Heart Ventricles - pathology; Heart Ventricles - physiopathology; Humans; Image Enhancement; Logistic Models; Magnetic resonance; Magnetic Resonance Imaging, Cine; Male; Middle Aged; Myocardial Contraction; Patient outcomes; Predictive Value of Tests; Recovery of Function; ROC Curve; Stroke Volume; Treatment Outcome; Ventricular Function, Left
• ISSN: 1097-6647; 1532-429X; 1532-429X
• DOI: 10.1186/1532-429X-10-41

The objective was to compare the value of late gadolinium enhancement (LGE) and end-diastolic wall thickness (EDWT) assessed by cardiovascular magnetic resonance (CMR) in predicting recovery of left ventricular function after coronary artery bypass surgery (CABG). We enrolled patients with coronary artery disease and left ventricular ejection fraction < 45% who were scheduled for CABG. Regional contractility was assessed by cine CMR at baseline and 4 months after CABG. EDWT and LGE were assessed at baseline. Predictors for improvement of regional contractility were analyzed. We studied 46 men and 4 women with an average age of 61 years. Baseline left ventricular ejection fraction was 37 +/- 13%. A total of 2,020 myocardial segments were analyzed. Abnormal wall motion and the LGE area were detected in 1,446 segments (71.6%) and 1,196 segments (59.2%) respectively. Wall motion improvement was demonstrated in 481 of 1,227 segments (39.2%) that initially had wall motion abnormalities at baseline. Logistic regression analysis showed that the LGE area, EDWT and resting wall motion grade predicted wall motion improvement. Comparison of Receiver-Operator-Characteristic (ROC) curves demonstrated that the LGE area was the most important predictor (p < 0.001). Adding information from LGE to the EDWT can decrease the number of false predictions by EDWT alone from 483 to 127 segments. LGE and EDWT are independent predictors for functional recovery after revascularization. However, LGE appears to be a more important factor and independent of EDWT.