Key result
In patients with preserved LVEF undergoing CABG, those with reduced preoperative global longitudinal strain (< -17%) showed significant postoperative improvement in strain parameters (p=0.004).
Why the study?
The role of CABG on postoperative LV function in patients with preoperatively preserved LVEF remains debated, with few studies addressing this question.
Does CABG improve left ventricular longitudinal strain in CAD patients with preoperatively preserved LVEF?
Observational (n=59)
No
Does CABG improve left ventricular longitudinal strain in CAD patients with preoperatively preserved LVEF?
p-value: p=0.004
CABG improves LV systolic and diastolic function measured by strain and tissue Doppler in CAD patients with preserved LVEF, particularly those with reduced preoperative global longitudinal strain.
Strain may improve post-CABG in preserved-LVEF patients with low preoperative GLS; hypothesis-generating, needs RCTs.
Background and Objectives: The role of coronary artery bypass grafting (CABG) on postoperative left ventricular (LV) function in patients with preoperatively preserved left ventricular ejection fraction (LVEF) is still being discussed and only a few studies address this question. This study aimed to assess LV function after CABG in patients with preoperatively preserved LVEF using left ventricular longitudinal strain assessed by 2D speckle tracking imaging (STI). Materials and Methods: Fifty-nine consecutive adult patients with coronary artery disease (CAD) referred for a first-time elective CABG surgery were enrolled in the final analysis of this prospective single-center clinical study. Transthoracic echocardiography (TTE), with conventional measures and STI measures, was performed within 1 week before CABG as well as 4 months after surgery. Patients were divided into groups based on their preoperative global longitudinal strain (GLS) value. Differences in systolic and diastolic parameters between groups were analyzed. Results: Preoperative GLS was reduced (GLS < −17%) in 39% of the patients. Parameters of systolic LV function were significantly reduced in this group of patients compared to the patient group with GLS% ≥ −17%. In both groups, 4 months after CABG there was a decline in LVEF but statistically significant only in the group with GLS% ≥ −17% (p = 0.035). In patients with reduced GLS, there was a statistically significant postoperative improvement (p = 0.004). In patients with preoperative normal GLS, there was not a significant change in any strain parameters after CABG. There was an improvement in diastolic function parameters measured by Tissue Doppler Imaging (TDI) in both groups. Conclusions: There is improvement in LV systolic and diastolic function after CABG in patients with preserved preoperative LVEF measured by STI and TDI. GLS might be more sensitive and effective than LVEF for monitoring improvements in myocardial function after CABG surgery in patients with preserved LVEF.
No takes yet. Share an insight, caveat, or question.
Papestiev et al. (2023) conducted an observational in Coronary artery disease with preoperatively preserved LVEF (n=59). Reduced preoperative global longitudinal strain (GLS < -17%) vs. Normal preoperative global longitudinal strain (GLS ≥ -17%) was evaluated on Postoperative improvement in global longitudinal strain (p=0.004). In patients with preserved LVEF undergoing CABG, those with reduced preoperative global longitudinal strain (< -17%) showed significant postoperative improvement in strain parameters (p=0.004).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: