Perioperative changes in left ventricular systolic function following surgical revascularization

Nearly 1/3.sup.rd of patients undergoing coronary artery bypass graft surgery (CABG) have left ventricular systolic dysfunction. However, the extent, direction and implications of perioperative changes in left ventricular ejection fraction (LVEF) have not been well characterized in these patients. W...

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Published inPloS one Vol. 17; no. 11; p. e0277454
Main Authors Downey, Michael C, Hooks, Matthew, Gravely, Amy, Naksuk, Niyada, Buelt-Gebhardt, Melissa, Carlson, Selma, Tholakanahalli, Venkat, Adabag, Selçuk
Format Journal Article
LanguageEnglish
Published San Francisco Public Library of Science 10.11.2022
Subjects
Biology and Life Sciences
Cardiomyopathy
Cardiovascular disease
Complications and side effects
Congestive heart failure
Consent
Coronary artery
Coronary artery bypass
Coronary vessels
Ejection fraction
Health risks
Heart failure
Heart surgery
Hypotheses
Ischemia
Laboratories
Medicine and Health Sciences
Mortality
Patient outcomes
Patients
Regression analysis
Sensitivity analysis
Survival
Survival analysis
Variables
Vein & artery diseases
Ventricle
United States
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Summary:Nearly 1/3.sup.rd of patients undergoing coronary artery bypass graft surgery (CABG) have left ventricular systolic dysfunction. However, the extent, direction and implications of perioperative changes in left ventricular ejection fraction (LVEF) have not been well characterized in these patients. We studied the changes in LVEF among 549 patients with left ventricular systolic dysfunction (LVEF 10% in LVEF was considered clinically significant. Of the 549 patients (mean age 61.4±9.55 years, and 72 [13.1%] women), 145 (26.4%) had a >10% improvement in LVEF, 369 (67.2%) had no change and 35 (6.4%) had >10% worsening of LVEF following CABG. Patients with lower preoperative LVEF were more likely to experience an improvement after CABG (odds ratio 1.36; 95% CI 1.21-1.53; per 5% lower preoperative LVEF; p 10% improvement in LVEF after CABG was associated with a 57% lower risk of all-cause mortality (HR: 0.43, 95% CI: 0.26-0.71). Among patients with ischemic cardiomyopathy undergoing CABG, 26.4% had >10% improvement in LVEF. An improvement in LVEF was more likely in patients with lower preoperative LVEF and was associated with improved long-term survival.
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Competing Interests: The authors have declared that no competing interests exist.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0277454