Key result
In CAD patients 18 months after CABG, right ventricular systolic dysfunction increased from 7.5% to 30% (p<0.001) and diastolic dysfunction increased from 41.8% to 57.5% (p<0.001).
Why the study?
Right ventricular dysfunction after CABG increases mortality and morbidity, but changes in RV diastolic function after surgery have rarely been studied.
Does coronary artery bypass grafting affect right ventricular systolic and diastolic function at 18 months post-surgery in patients with CAD?
Observational (n=196)
Does coronary artery bypass grafting affect right ventricular systolic and diastolic function at 18 months post-surgery in patients with CAD?
Absolute Event Rate: 30% vs 7.5%
p-value: p=<0.001
Coronary artery bypass grafting is associated with a significant increase in the frequency of both right ventricular systolic and diastolic dysfunction at 18 months post-surgery.
RV systolic/diastolic dysfunction frequency rises 18 months post-CABG; leaves open prognostic significance and need for prospective validation.
Objective. Right ventricular (RV) dysfunction after coronary artery bypass grafting (CABG) is associated with increased mortality and morbidity. In previous studies, the parameters of RV systolic function were mainly assessed, while the dynamics of RV diastolic function after surgery was practically not studied. The aim of this study was to study the dynamics of indicators of systolic and diastolic RV function after CABG as well as to identify factors associated with their presence. Methods. The study included 160 patients who underwent CABG and 36 volunteers with no history of coronary artery disease (CAD) as a control group. Echocardiographic examination of patients was performed to assess systolic and diastolic RV dysfunction before surgery and 18 months after CABG. A level of s’t < 10 cm/sec or TAPSE < 16 mm was considered as a sign of existing RV systolic dysfunction. RV diastolic dysfunction was defined as an Et/At ratio < 0.8 or >2.1 and/or an Et/et’ ratio > 6. Results. In CAD patients 18 months after CABG, there was an increase in the frequency of the right ventricular systolic (from 7.5% to 30%, p < 0.001) and diastolic (from 41.8% to 57.5%, p < 0.001) dysfunction. An increase in TAPSE (p = 0.007), a decrease in e’t (p = 0.005), and the presence of RV systolic dysfunction before surgery (p = 0.023) was associated with a significant increase in the likelihood of detecting RV systolic dysfunction 18 months after CABG (χ2(3) = 17.4, p = 0.001). High values of At before surgery (p = 0.021) and old myocardial infarction (p = 0.023) were significantly associated with an increased likelihood of detection of RV diastolic dysfunction 18 months after CABG (χ2(2) = 10.78, p = 0.005). Conclusions. This study demonstrated that in CAD patients 18 months after CABG, there was an increase in the frequency of right ventricular systolic and diastolic dysfunction. We also established the initial clinical, echocardiographic parameters, and perioperative complications associated with the presence of these changes in the postoperative period. The clinical and prognostic significance of the presence of systolic and/or diastolic RV dysfunction in patients 18 months after CABG remains to be explored.
No takes yet. Share an insight, caveat, or question.
Сумин et al. (2022) conducted an observational in Coronary artery disease (n=196). Coronary artery bypass grafting (CABG) vs. Before surgery (baseline) was evaluated on Right ventricular systolic dysfunction (p=<0.001). In CAD patients 18 months after CABG, right ventricular systolic dysfunction increased from 7.5% to 30% (p<0.001) and diastolic dysfunction increased from 41.8% to 57.5% (p<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: