Early Assessment of Rest and Exercise Left Ventricular Function Following Coronary Artery Surgery

• Published in: The Annals of thoracic surgery Vol. 35; no. 2; pp. 159 - 169
• Main Authors: Austin, Erie H., Oldham, H. Newland, Sabiston, David C., Jones, Robert H.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.02.1983
• Subjects: Aged; Angina Pectoris - diagnostic imaging; Angina Pectoris - physiopathology; Angina Pectoris - surgery; Coronary Artery Bypass; Coronary Vessels - diagnostic imaging; Heart - physiology; Heart Function Tests; Hemodynamics; Humans; Male; Middle Aged; Myocardial Contraction; Physical Exertion; Postoperative Period; Radionuclide Imaging; Rest; Stroke Volume; Time Factors
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/S0003-4975(10)61454-3

Radionuclide assessment of rest and exercise left ventricular function was performed in 14 patients before, eight days after, and three months after coronary artery bypass grafting (CABG). Resting function was unaltered after operation, although mild increases in heart rate and end-diastolic volume were observed on the eighth postoperative day. In contrast, exercise function was significantly improved at both postoperative time periods. Exercise ejection fraction was 0.54 ± 0.10 before operation, 0.73 ± 0.12 at eight days, and 0.64 ± 0.13 at three months. Before CABG, the exercise-induced increase in stroke volume was achieved by an increase in end-diastolic volume, whereas eight days after CABG this increase was achieved by an increase in contractility (systolic blood pressure/end-systolic volume). By three months, both contractility and end-diastolic volume increased with exercise. Thus, improvement in left ventricular function during exercise can be documented as early as eight days after coronary revascularization. This change may be less pronounced after three months of convalescence, but considerable improvement in ventricular function persists compared to preoperative assessment.