Key result
Reversible ventricular dysfunction and depressed metabolism after CABG reflect myocardial stunning.
Why the study?
Measurements of regional myocardial function and perfusion to assess myocardial stunning after CABG surgery are difficult in clinical settings, despite frequent symptoms suggesting its occurrence.
Clinical, functional, and metabolic data support the occurrence of myocardial stunning after CABG surgery, with new imaging techniques likely to improve future assessment.
May indicate stunning contributes to post-CABG dysfunction; hypothesis-generating and should not yet change practice.
Although patients who have undergone coronary artery bypass graft (CABG) surgery frequently present with symptoms suggesting that myocardial stunning has occurred, measurements of regional myocardial function and perfusion are difficult in clinical settings. Several studies have used left ventricular function indices (i.e., cardiac index, left ventricular stroke work index, ejection fraction) to assess myocardial stunning immediately following CABG surgery. These changes in ventricular function have been found to be reversible and the clinical data are consistent with the occurrence of myocardial stunning. Myocardial metabolism is also reportedly depressed following CABG surgery. Decreases in myocardial oxygen extraction, consumption, and lactate utilization all point to the presence of myocardial stunning, as do abnormalities in regional wall-motion and electrocardiographic changes (i.e., transient Q waves) described in patients who have undergone CABG surgery. New approaches to differentiating viable from nonviable myocardial tissue will likely include stress echocardiography using new stress agents, ultrasound contrast agents, and high frequency ultrasound.
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Jacqueline M. Leung (1993) conducted a review in Myocardial stunning following CABG surgery. Coronary artery bypass graft (CABG) surgery was evaluated. Reversible changes in ventricular function and depressed myocardial metabolism following CABG surgery are consistent with the occurrence of myocardial stunning.
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