Key result
RV dysfunction affects ~49% of patients six months post-CABG and is linked to reduced 6-MWT distance.
Why the study?
Right ventricular dysfunction is an important complication after CABG that may affect longevity and functional capacity, but its relationship with parameters like IVC size and physical capacity needed evaluation.
Does coronary artery bypass grafting lead to right ventricular dysfunction and impaired functional capacity at 6 months follow-up?
Observational (n=61)
Does coronary artery bypass grafting lead to right ventricular dysfunction and impaired functional capacity at 6 months follow-up?
p-value: p=<0.001
A significant proportion of patients develop right ventricular dysfunction after CABG, which is associated with reduced exercise capacity at 6 months.
May reduce functional capacity after CABG; hypothesis-generating and requires prospective validation before practice change.
BACKGROUND: Coronary artery bypass grafting (CABG) surgery is widely accepted as a revascularization method for coronary artery disease (CAD). Despite survival benefit and improvement in quality of life, CABG may impose major morbidities and significant complications. Right ventricle (RV) dysfunction is an important complication that may affect patient's longevity and functional capacity. The aim of this study was to evaluate the relationship between RV dysfunction and some invisible parameters like inferior vena cava (IVC) size with physical capacity. METHODS: In this prospective study, 61 eligible CABG candidates were enrolled and RV function was assessed by echocardiographic parameters before CABG and one week and six months after the procedure, using tricuspid annular plane systolic excursion (TAPSE), Tei Index (TI), peak systolic movement (Sm) (cm/s), and IVC size. Functional capacity was assessed by six-minute walk test (6-MWT) 6 months after CABG. RESULTS: 58 patients who did not have any perioperative RV dysfunction were remained until the end of study; mean age was 58.2 ± 7.9 years with 68.9% being men, and 3 patients died after CABG. Preoperatively, septal motion, RV indices, and IVC size were normal in all patients. The frequency of RV dysfunction according to abnormal TAPSE index, TI, and peak Sm one week after surgery was 81.0%, 79.0%, and 62.0%, respectively, and 6 months after surgery was 49.0%, 49.0%, and 37.0%, respectively. Mean walked distance in 6-MWT was significantly less in patients with RV dysfunction, older age, and higher number of involved vessels (P < 0.001). CONCLUSION: The significant reduction in RV function and impairment of exercise capacity after CABG in this study suggests cardiologists to pay more attention to RV assessment in follow-up visits of patients undergoing GABG.
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Chinikar et al. (2019) conducted an observational in Coronary artery disease requiring CABG (n=61). Right ventricular dysfunction vs. Normal right ventricular function was evaluated on Mean walked distance in 6-minute walk test (6-MWT) (p=<0.001). Right ventricular dysfunction occurred in up to 49% of patients 6 months after CABG and was associated with significantly reduced 6-minute walk test distance (P < 0.001).
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