Key result
Pre-operative left ventricular dyssynchrony, specifically Tmsv16-SD%, was independently associated with an increased risk of short-term adverse outcomes after CABG (OR 1.362).
Why the study?
The predictive value of left ventricular dyssynchrony for short-term adverse outcomes in patients with three-vessel disease undergoing CABG with preserved or mildly reduced LVEF needed evaluation.
Does pre-operative left ventricular dyssynchrony assessed by RT-3DE predict short-term adverse outcomes in patients with three-vessel disease undergoing CABG?
Observational (n=95)
No
Does pre-operative left ventricular dyssynchrony assessed by RT-3DE predict short-term adverse outcomes in patients with three-vessel disease undergoing CABG?
Pre-operative left ventricular dyssynchrony assessed by 3D echocardiography independently predicts 30-day mortality and postoperative complications in patients with three-vessel disease undergoing CABG.
LV dyssynchrony may aid short-term risk stratification in 3VD CABG; leaves open prospective validation before clinical use.
Background and objective Coronary artery bypass grafting (CABG) is the reference standard intervention in coronary artery disease (CAD) patients with three-vessel disease (3VD). We aimed to evaluate the predictive value of left ventricular (LV) dyssynchrony for short-term adverse outcomes in patients with 3VD undergoing CABG with preserved or mildly reduced LV ejection fraction (LVEF). Materials and methods This study involved ninety-five 3VD patients with preserved or mildly reduced LVEF undergoing scheduled on-pump CABG. The pre-operative diameters and volumes of LV and LVEF were obtained by two-dimensional echocardiography. LV dyssynchrony parameters were acquired by real-time three-dimensional echocardiography (RT-3DE) and analyzed by HeartModel quantification software. And the perfusion index of LV was obtained by contrast echocardiography. The clinical endpoints of short-term adverse outcomes comprised 30-day mortality and/or composite outcomes of postoperative complications. Univariate and multivariate logistic regression analyses were used to identify risk factors for the occurrence of post-CABG short-term adverse outcomes. Results Short-term adverse outcomes occurred in 12 (12.6%) patients. These patients had higher LV dyssynchrony parameters obtained through RT-3DE. The standard deviation (SD) of the time to minimum systolic volume (Tmsv) corrected by heart rate over 16 segments (Tmsv16-SD%) [odds ratio (OR), 1.362; 95% confidence interval (CI) (1.090–1.702); P = 0.006], one of the LV dyssynchrony parameters, was independently associated with short-term adverse outcomes. Patients with poor synchronization tended to spend more time in the intensive care unit (ICU) and hospital after surgery. Conclusion Pre-operative LV dyssynchrony parameter Tmsv16-SD% obtained through RT-3DE could be a useful additional predictor of postoperative short-term adverse outcomes in 3VD patients with preserved or mildly reduced LVEF undergoing CABG.
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Liu et al. (2022) conducted an observational in Three-vessel coronary artery disease with preserved or mildly reduced LVEF (n=95). Pre-operative left ventricular dyssynchrony (Tmsv16-SD%) vs. Normal left ventricular synchrony was evaluated on 30-day mortality and/or composite outcomes of postoperative complications (OR 1.362, 95% CI 1.090-1.702, p=0.006). Pre-operative left ventricular dyssynchrony, specifically Tmsv16-SD%, was independently associated with an increased risk of short-term adverse outcomes after CABG (OR 1.362).
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