Key result
CABG improves LVEF by ~7 percentage points but leaves persistent dyssynchrony in most patients.
Why the study?
Data demonstrating CABG benefits in patients with significant left intraventricular dyssynchrony are limited, and whether myocardial viability quantified by DSE predicts postoperative dyssynchrony improvement is unclear.
Does coronary artery bypass grafting improve left ventricular dyssynchrony in patients with ischemic cardiomyopathy and viable myocardium?
Cross-Sectional (n=30)
No
Does coronary artery bypass grafting improve left ventricular dyssynchrony in patients with ischemic cardiomyopathy and viable myocardium?
Absolute Event Rate: 39.6% vs 32.2%
p-value: p=<0.001
While CABG significantly improves global left ventricular ejection fraction and dimensions, it resolves mechanical dyssynchrony in only 30% of patients, indicating that cardiac resynchronization therapy (CRT) should still be considered for the majority.
Post-CABG LVEF gains without dyssynchrony resolution in most; leaves open predictive role of dobutamine echo and need for adjunctive CRT.
Background: For patients with advanced, diffuse Coronary artery disease (CAD), surgical myocardial revascularization via coronary artery bypass grafting (CABG) continues to represent the gold standard therapeutic approach. Given the paucity of studies demonstrating CABG benefits in patients with significant left intraventricular dyssynchrony (LVD), we conducted this study to evaluate how viable myocardial tissue volume, quantified by dobutamine stress echocardiography (DSE), predicts postoperative LVD improvement. Methods: This investigation employed a cross-sectional analytical design to assess 30 CABG candidates with moderate-severe ischemic cardiomyopathy. Myocardial viability evaluation utilized dobutamine stress echocardiography, complemented by tissue Doppler Imaging for synchronized assessment of regional LV contractility. Results: Demographic analysis revealed a study population aged 61.5±7.9 years (range: 47 to 85 years), comprising 73.3% males. Left ventricular ejection fraction (LVEF) measurements improved from 32.2±4.6% at baseline to 39.6±5.2 % following surgical revascularization (p<0.001). Postoperative resolution of left ventricular dyssynchrony occurred in 9 patients (30.0 %), whereas 19 patients (63.3 %) showed no improvement (p<0.001). Two patients (6.6 %) died due to progressive heart failure and inadequate revascularization. Conclusion: Our current study demonstrates significant postoperative improvements in LVEF, LVEDD, and left ventricular dyssynchrony. However, given that approximately two-thirds of cases showed only minimal improvement in dyssynchrony, it would be reasonable to consider cardiac resynchronization therapy (CRT) for these patients.
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Salehi et al. (2026) conducted a cross-sectional in moderate-to-severe ischemic cardiomyopathy with left ventricular dyssynchrony (n=30). Coronary artery bypass grafting (CABG) vs. Baseline (Pre-CABG) was evaluated on Left ventricular ejection fraction (LVEF) (p=<0.001). Coronary artery bypass grafting significantly improved mean left ventricular ejection fraction from 32.2% to 39.6% (p<0.001), but failed to resolve left ventricular dyssynchrony in 63.3% of patients.
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