Effect of coronary artery bypass surgery on left ventricular function as assessed by strain and strain rate imaging

Durmaz, Tahir; Bayram, Hüseyin; Bayram, NA; Sarı, Cenk; Keleş, Telat; Baştuğ, Serdal; Bozkurt, Engin

doi:10.1177/0267659113513920

Cited by 2 publications

(3 citation statements)

References 22 publications

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“…In a small study [9] of 25 children (age 9.4 ± 9.8 years), evaluating 3D LV ventricular strain at 1 week and 1 month after cardiac surgery for CHD, no significant differences in regional deformation were noted, except for a more pronounced reduction in strain values in the LV-free wall middle segments for cyanotic patients (p = 0.037). Curiously, the trend in postoperative apical hypercontractility we described herein is opposite to the one previously reported in adult [25,26] patients. In 182 patients, following different types of cardiac surgery (e.g., aortic valve replacement, mitral valve repair or replacement, coronary artery bypass graft), segmental function evaluated by 3D strain was greatly impaired in apical when compared to basal segments.…”

Section: Discussioncontrasting

confidence: 99%

“…In this study [25], however, many patients had left anterior descending coronary artery disease; thus, the differences in regional strain may be attributed to pre-existing coronary artery disease. The basal and middle segment strain values, in fact, seem to be ameliorated after coronary artery bypass surgery due to revascularization [25,26]. Thus, a comparison of adult data with those of children who usually have a normal coronary artery bed is difficult and should be avoided.…”

Section: Discussionmentioning

confidence: 99%

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Left Ventricular Systolic Impairment after Pediatric Cardiac Surgery Assessed by STE Analysis

et al. 2021

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Background: Speckle-tracking echocardiography (STE) has gained increasing value in the evaluation of congenital heart diseases (CHD); however, its use in pediatric cardiac surgery is limited. Aim: To evaluate left ventricular (LV) systolic impairment after biventricular pediatric cardiac surgery by STE strain (ε) analysis. Methods: We prospectively enrolled 117 children undergoing cardiac surgery for CHD. Echocardiography was performed at four different times: pre-operatively, 12–36 h (Time 1), 3–5 days (Time 2), and 6–8 days (Time 3). Images were obtained in the 4-2-and 3 apical chamber’s views to derive LV global and regional (basal/mid/apical) ε values. Results: At different postoperative times, we performed 320 examinations in 117 children (mean age: 2.4 ± 3.9, range: 0–16 years); 117 age-matched healthy children served as controls. All global, basal, and mid LVε values decreased after surgery; the lowest values being at Time 1 (p < 0.0001), which increased thereafter. At discharge, all global, basal, and mid LVε values remained lower than in pre-operative and healthy children (p < 0.05). Instead, apical segments (lowest at baseline) increased after surgery (p < 0.0001) but remained lower compared to controls. LV ejection fraction (LVEF) decreased at Time 1 (p = 0.0004) but promptly recovered to Time 2 and normalized at Time 3. Conclusions: STE ε analysis revealed a significant LV systolic impairment after surgery with amelioration thereafter but incomplete normalization at discharge. Base-apex differences emerged with apical segments that, contrary to all the other regions, showed relative hypercontractility after surgery. The slower recovery of LVε values compared to LVEF suggests that STE ε analysis may be more accurate for the follow-up of mild LV post-surgical impairment.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Left Ventricular Systolic Impairment after Pediatric Cardiac Surgery Assessed by STE Analysis

et al. 2021

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“…In the entire cohort, there was a significant improvement in global LV strain after CABG ( p = 0.03). This supports the findings of Yin et al [ 6 ] and Durmaz et al [ 20 ] who showed an improvement in the longitudinal deformation in patients with preserved LVEF after CABG. We believe that this finding is of exceptional clinical importance for two reasons: first, it confirms the success of myocardial revascularization and confirms the “awakening” of the subtly hibernating segments of the myocardium.…”

Section: Discussionsupporting

confidence: 92%

Myocardial Function after Coronary Artery Bypass Grafting in Patients with Preoperative Preserved Left Ventricular Ejection Fraction—The Role of the Left Ventricular Longitudinal Strain

et al. 2023

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Background and Objectives: The role of coronary artery bypass grafting (CABG) on postoperative left ventricular (LV) function in patients with preoperatively preserved left ventricular ejection fraction (LVEF) is still being discussed and only a few studies address this question. This study aimed to assess LV function after CABG in patients with preoperatively preserved LVEF using left ventricular longitudinal strain assessed by 2D speckle tracking imaging (STI). Materials and Methods: Fifty-nine consecutive adult patients with coronary artery disease (CAD) referred for a first-time elective CABG surgery were enrolled in the final analysis of this prospective single-center clinical study. Transthoracic echocardiography (TTE), with conventional measures and STI measures, was performed within 1 week before CABG as well as 4 months after surgery. Patients were divided into groups based on their preoperative global longitudinal strain (GLS) value. Differences in systolic and diastolic parameters between groups were analyzed. Results: Preoperative GLS was reduced (GLS < −17%) in 39% of the patients. Parameters of systolic LV function were significantly reduced in this group of patients compared to the patient group with GLS% ≥ −17%. In both groups, 4 months after CABG there was a decline in LVEF but statistically significant only in the group with GLS% ≥ −17% (p = 0.035). In patients with reduced GLS, there was a statistically significant postoperative improvement (p = 0.004). In patients with preoperative normal GLS, there was not a significant change in any strain parameters after CABG. There was an improvement in diastolic function parameters measured by Tissue Doppler Imaging (TDI) in both groups. Conclusions: There is improvement in LV systolic and diastolic function after CABG in patients with preserved preoperative LVEF measured by STI and TDI. GLS might be more sensitive and effective than LVEF for monitoring improvements in myocardial function after CABG surgery in patients with preserved LVEF.

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Effect of coronary artery bypass surgery on left ventricular function as assessed by strain and strain rate imaging

Abstract: The results of this study suggest that strain and strain rate echocardiography can provide an accurate evaluation of regional contractile function after CABG, even in the segments that are apparently normal.

Cited by 2 publications

References 22 publications

Left Ventricular Systolic Impairment after Pediatric Cardiac Surgery Assessed by STE Analysis

Left Ventricular Systolic Impairment after Pediatric Cardiac Surgery Assessed by STE Analysis

Myocardial Function after Coronary Artery Bypass Grafting in Patients with Preoperative Preserved Left Ventricular Ejection Fraction—The Role of the Left Ventricular Longitudinal Strain

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