Left ventricle diastolic function in the patients after coronary arteries bypass graft combined with left ventricle aneurismectomy according to tissue doppler imaging: one year follow-up

Abstract

Left ventricle diastolic function in the patients after coronary arteries bypass graft combined with left ventricle aneurismectomy according to tissue doppler imaging: one year follow-up Maryna N Dolzhenko, S A Rudenko, S V Potashev, T V Simagina, N N Nosenko, T G Kravchenko Aim: To evaluate left ventricle (LV) diastolic function dynamics in patients after acute myocardial infarction (AMI) after combined operation of coronary artery bypass graft with LV aneurismectomy (CABG + AE) according to the results of tissue Doppler imaging (TDI). Methods: Forty patients after AMI underwent Doppler echocardiography (EchoCG) with TDI and M-mode colour-flow imaging before and in 3 and 12 months after CABG + AE. Mitral annulus (MA) TDI with velocity indices was performed in 4 segments of LV. Results: Conventional transmitral diastolic Doppler indices before and after CABG + AE remained unchanged. TDI showed significant improvement of LV systolic (systolic movement velocity S: 6.1¡0.8, 7.4¡1.2 and 6.9¡1.3 cm/sec. before and in 3 and 12 months after the operation, respectively, p,0.01) and diastolic function after the operation (MA early diastolic movement velocity ( e'): 7.3 ¡ 2.1, 8.4 ¡ 1.5 and 8.9 ¡ 1.8 cm/s.; ratio of transmitral early-flow velocity (E) to MA early-diastolic movement velocity (E/ e'): 18.4 ¡ 2.2, 12.3 ¡ 1.8 and 11.5 ¡ 2.3; ratio of E diastolic flow propagation velocity (Vp) 3.1 ¡ 0.45, 2.2 ¡ 0.38 and 1.8 ¡ 0.16 before and in 3 and 12 months after the operation, respectively, p,0.01). Conclusions:Results of the study demonstrate significant improvement of LV diastolic function in the patient after CABG + AE according to TDI, regardless of transmitral flow pattern. TDI is more sensitive and preload independent method of LV myocardial function evaluation.

Effects of surgical ventricular reconstruction on diastolic function at midterm follow-up

“…Therefore, tissue Doppler velocity curves that are load independent and more sensitive than conventional transmitral flow indices and/or 3-dimensional echocardiography in experienced hands are undeniably better tools to refine these measurements. 19,20 Finally, the study is retrospective, nonrandomized, and not powered for mortality; therefore, inasmuch as the sample size is small, the events are few, and a control group having coronary artery bypass without SVR is lacking, we cannot drive conclusions on the clinical impact of diastolic dysfunction on outcome after SVR. The recently released STICH trial results (Surgical Trial in IntraCerebral Haemorrhage) showed that SVR does not add benefit in respect to coronary artery bypass alone, but the article does not report data either preoperatively or postoperatively on diastolic function.…”

Left Ventricle Postinfarction Aneurism: Comparison Between Diagnostic Value of Different Methods of Visualization

“…Despite the fact that CVG is considered to be an invasive "golden standard" in diagnosing LV structural pathology, high accuracy of MSCT and EchoCG is explained due to visualization of the whole LV wall with characteristic myocardial signal. During CVG invasive cardiologist sees only endocardial contour outlined by contrast, which might be a cause of false positive or false negative diagnosis, especially in case of a small aneurism, which is shown by our study data by intraoperational findings of LV aneurism and its thrombosis and corresponds to reference data (Budoff, 2004;Dirksen et al, 2002;Dolzhenko et al, 2007;Masaki et al, 2005;Schuijf et al, 2004). Besides, during MSCT or EchoCG thrombotic tissue has certain structural texture, significantly visually different from one of myocardium, which explains higher accuracy of these methods in aneurism thrombosis diagnosis compared to CVG, especially in case of flat and thin parietal clot (Laissy et al, 2007), when CVG does not show significant contrast filling defect.…”

“…In case of defining LV volumes and EF EchoCG is the method of preference being reliable, non-invasive and, thus, having minimum of limitations (Becher et al, 2004;Budoff, 2004;Dolzhenko et al, 2007;Swedberg et al, 2005). Despite good correlations between all methods of visualization, MSCT seemed to give seriously lower absolute values of LV EF compared to EchoCG.…”

“…Postinfarction LV aneurism promotes LV remodeling, worsens its systolic and diastolic function. LV myocardial function may improve in case of adequate vascularization revival due to surgeon procedure, for instance coronary arteries bypass graft (CABG) (Becher et al, 2004;Budoff, 2004;Dirksen et al, 2002;Dolzhenko et al. 2007).…”

Late cardiac effect of anthracycline therapy in physically active breast cancer survivors – a prospective study

“…This method is suitable to establish the diagnosis or for the follow-up. The real diagnostic value in case of diastolic dysfunction has been proofed [6,7,8], compared to traditional methods [9] or to other imaging techniques [10].…”