The influence of aortocoronary bypass surgery on left ventricular function was studied in 53 patients with previous myocardial infarction (MI). Each patient underwent gated radionuclide left ventriculography 2-3 days before and 6 months after coronary artery bypass surgery. After surgery, global ventricular ejection fraction showed a mild increase, anteroseptal wall motion had a significant impairment, apical motion slightly increased, while inferoposterior motion significantly increased. Peak ejection rate slightly increased, while the significant increase of peak filling rate confirmed that diastolic ventricular damage was a reversible disturbance related to myocardial ischemia. The 23 patients with complete revascularization of a previous anterior MI showed a mild increase of global and regional wall motion. In 21 of the 30 patients with previous inferior MI, complete revascularization of the periinfarction area was feasible. After surgery, in this group, global and apical wall motion increased, inferoposterior motion showed a clear-cut increase. In the other 9 patients, who had incomplete revascularization of the inferior peri-infarction area, global and apical wall motion decreased, peak filling rate and particularly inferoposterior motion were unchanged. Our results suggest that reperfusion of ischemic muscle in and around areas of previous MI, particularly of inferior MI, can improve regional contraction in the same areas. In the patients with the worst evolution of the observed parameters, there was a good correlation between clinical picture, radionuclide investigation and coronary angiography.
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