Key result
CABG is linked to less LV remodeling and higher LVEF vs stenting at 6–12 months.
Why the study?
Left ventricular myocardial remodeling after MI is associated with worse prognosis, and revascularization may slow this process. This study sought to identify structural and functional cardiac remodeling parameters affecting prognosis and survival after coronary revascularization and compare them between CABG and coronary artery stenting.
Does coronary artery bypass grafting (CABG) improve echocardiographic parameters of left ventricular remodeling compared to coronary artery stenting (CAS) in patients with coronary artery disease and reduced ejection fraction?
Observational (n=104)
Does coronary artery bypass grafting (CABG) improve echocardiographic parameters of left ventricular remodeling compared to coronary artery stenting (CAS) in patients with coronary artery disease and reduced ejection fraction?
In patients with coronary artery disease and reduced ejection fraction, coronary artery bypass grafting is associated with more favorable echocardiographic indices of left ventricular remodeling and higher ejection fraction at 6–12 months compared to coronary stenting.
Cautious support for CABG in reduced-EF CAD; hypothesis-generating, leaves open need for RCTs before practice change.
Left ventricular (LV) myocardial remodeling after myocardial infarction (MI) is associated with worse prognosis in most cases. In some cases, inaddition to optimal drug therapy, surgical revascularization can be used to stop or slow down the remodeling process. The aim of this study was to identify structural and functional parameters of cardiac remodeling that affect the prognosis and survival of patients after coronary revascularization performed by anyone method, and to compare these parameters in groups of patients who underwent coronary artery bypass grafting (CABG) and coronary artery stenting (CAS). A total of 104 patients with coronary artery disease and reduced ejection fraction (EF) were examined before, shortly after (5–10 days), and 6–12 months after myocardial revascularization. The average age of patients was 58 [54; 66] years old, including 85% men and 15% women. 82% of patients were operated on, of which 62 (59.6%) patients underwent CABG and 23 (22.1%) patients underwent CAS. Complete revascularization was achieved in 24 (28.2%) cases. In addition to the standard linear and volumetric dimensions, the sphericity index was calculated in diastole (end-diastolic diameter, EDD/longitudinal dimension of the LV in diastole) and systole (end-sistolic diameter, ESD/longitudinal dimension of the LV in systole), as well as the integral systolic remodeling index (ISRI), as the ratio of EF to the diastolic sphericity index of the LV in units. The remodeling parameters of interest for assessing the results of revascularization include EDVI, LVEF, diastolic sphericity index and integral systolic remodeling index. In patients who underwent CABG, these parameters reflected a lower degree of left ventricular remodeling: lower left ventricular end-diastolic volume index, diastolic sphericity index, and integral systolic remodeling index, and higher left ventricular ejection fraction.
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Andreeva et al. (2025) conducted an observational in Coronary artery disease with reduced ejection fraction (n=104). Coronary artery bypass grafting (CABG) vs. Coronary artery stenting (CAS) was evaluated on Echocardiographic parameters of left ventricular remodeling (EDVI, LVEF, diastolic sphericity index, and integral systolic remodeling index). CABG (59.6% of cohort) vs CAS (22.1%) was associated with less LV remodeling (lower EDVI, diastolic sphericity index, and ISRI, and higher LVEF) at 6–12 months.
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