Significance of changes in resting left ventricular ejection fraction after coronary artery bypass grafting

• Published in: The Journal of thoracic and cardiovascular surgery Vol. 102; no. 5; pp. 736 - 744
• Main Authors: Jacobson, AF, Tow, DE, Lapsley, D, Barsamian, EM, Jose, M, Khuri, S
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA AATS/WTSA 01.11.1991; Elsevier
• Subjects: Adult; Aged; Arrhythmias, Cardiac - etiology; Biological and medical sciences; Bundle-Branch Block - etiology; Cardiac Tamponade - etiology; Coronary Artery Bypass - adverse effects; Female; Follow-Up Studies; Heart Block - etiology; Heart Diseases - diagnostic imaging; Heart Diseases - etiology; Heart Diseases - physiopathology; Humans; Male; Medical sciences; Middle Aged; Postoperative Period; Prognosis; Radionuclide Ventriculography; Reoperation; Stroke Volume - physiology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Ventricular Function, Left - physiology; Human; Treatment; Bypass; Surgery; Coronary artery; Cardiovascular disease; Coronary heart disease; Left ventricle; Ejection fraction
• ISSN: 0022-5223; 1097-685X
• DOI: 10.1016/s0022-5223(19)36867-9

The prognostic significance of changes in resting left ventricular ejection fraction was examined in 102 patients who underwent successful coronary artery bypass grafting. Between preoperative and early postoperative radionuclide ventriculography, mean resting left ventricular ejection fraction improved from 47.2% to 53.9% (p less than 0.01). Left ventricular ejection fraction increased by 5% or greater in 64 patients (63%), remained unchanged (within 4%) in 31 (30%), and decreased by at least 5% in 7 (7%). During 14 to 39 months (mean 27 months) of clinical follow-up, patients with normal preoperative left ventricular ejection fraction had a lower prevalence of recurrent angina, congestive heart failure, and mortality resulting from cardiovascular disease. Cardiovascular morbidity and mortality occurred with equal frequency for patients who did and did not show early postoperative improvement in left ventricular ejection fraction (36% versus 39%). Among 69 patients who had a third radionuclide ventriculography at late follow-up, left ventricular ejection fraction was less than the early postoperative value in 69% and less than the preoperative result in 36%. Patients with early postoperative improvement in left ventricular ejection fraction were more likely to retain resting left ventricular contractile function, at least at the preoperative level (71% versus 46%).