Key result
Coronary artery bypass graft combined with left ventricle aneurismectomy significantly improved left ventricle diastolic function at 12 months compared to baseline (P<0.01).
Why the study?
Does coronary artery bypass graft combined with left ventricle aneurismectomy improve left ventricular diastolic function in patients after acute myocardial infarction?
Observational (n=40)
Does coronary artery bypass graft combined with left ventricle aneurismectomy improve left ventricular diastolic function in patients after acute myocardial infarction?
p-value: p=<0.01
Tissue Doppler imaging demonstrates significant improvement in left ventricular diastolic function up to one year after combined CABG and LV aneurysmectomy, despite unchanged conventional Doppler indices.
May support combined CABG plus aneurysmectomy for post-MI diastolic recovery; leaves open need for randomized confirmation before practice change.
AIM: To evaluate left ventricle (LV) diastolic function dynamics in patients after acute myocardial infarction (AMI) after combined operation of coronary artery bypass graft with LV aneurismectomy (CABG + AE) according to the results of tissue Doppler imaging (TDI). METHODS: Forty patients after AMI underwent Doppler echocardiography (EchoCG) with TDI and M-mode colour-flow imaging before and in 3 and 12 months after CABG + AE. Mitral annulus (MA) TDI with velocity indices was performed in 4 segments of LV. RESULTS: Conventional transmitral diastolic Doppler indices before and after CABG + AE remained unchanged. TDI showed significant improvement of LV systolic (systolic movement velocity S: 6.1+/-0.8, 7.4+/-1.2 and 6.9+/-1.3 cm/sec. before and in 3 and 12 months after the operation, respectively, p<0.01) and diastolic function after the operation (MA early diastolic movement velocity (e'): 7.3 +/- 2.1, 8.4 +/- 1.5 and 8.9 +/- 1.8 cm/s.; ratio of transmitral early-flow velocity (E) to MA early-diastolic movement velocity (E/e'): 18.4 +/- 2.2, 12.3 +/- 1.8 and 11.5 +/- 2.3; ratio of E diastolic flow propagation velocity (Vp) 3.1 +/- 0.45, 2.2 +/- 0.38 and 1.8 +/- 0.16 before and in 3 and 12 months after the operation, respectively, p<0.01). CONCLUSIONS: Results of the study demonstrate significant improvement of LV diastolic function in the patient after CABG + AE according to TDI, regardless of transmitral flow pattern. TDI is more sensitive and preload independent method of LV myocardial function evaluation.
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Dolzhenko et al. (2007) conducted an observational in Acute myocardial infarction (n=40). Coronary artery bypass graft with left ventricle aneurismectomy vs. Baseline (before operation) was evaluated on Left ventricle diastolic function (MA early diastolic movement velocity e', E/e', E/Vp) (p=<0.01). Coronary artery bypass graft combined with left ventricle aneurismectomy significantly improved left ventricle diastolic function at 12 months compared to baseline (P<0.01).
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