Imagawa H, Kobayashi T, Yoshino T, Sakurai M, Satoh H, Fudemoto Y
Department of Circulatory Dynamics, Center for Adult Diseases, Osaka, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1991 Oct;39(10):1858-64.
The present study was designed to assess a left ventricular function, particularly contractile characteristics following coronary artery bypass grafting (CABG). The subject was 29 post-CABG patient consisting of 4 groups; 6 patients with complete revascularization (CR) and no myocardial infarction (MI) (CR.MI(-) group), with CR and MI (CR.MI(+) group), 5 with incomplete revascularization (IR) and no MI (IR.MI(-) group) and 8 with IR and MI (IR.MI(+) group). Ejection fraction (EF), systolic pressure/end-systolic volume index (SP/ESVI) and end-systolic volume index (EDVI) were evaluated utilizing radionuclide angiography at rest and during exercise (Ex). Increase of SP/ESVI and EF and no change of EDVI during Ex were observed in CR.MI(-) group. Increase of SP/ESVI and no change of EF and EDVI in CR.MI(+) group, no change of SP/ESVI, EF and EDVI in IR.MI(-) group and no change of SP/ESVI and EDVI and decrease of EF in IR.MI(+) group were observed. The SP/ESVI and EF of CR.MI(-) group were respectively highest among 4 groups and showed no difference compared with control group during Ex. Ex-induced increase ratio of SP/ESVI had linear correlations with Ex-induced increment of EF (r = 0.81, p less than 0.001) and Ex-induced increase ratio of EFVI (r = 0.54, p less than 0.005). It is concluded that both CR and no MI lead to normalization of EF and SP/ESVI during Ex. Furthermore, in the case of poor contractile reserve, systolic function may deteriorate in spite of increased preload during Ex.
本研究旨在评估冠状动脉旁路移植术（CABG）后左心室功能，尤其是收缩特性。研究对象为29例CABG术后患者，分为4组：6例完全血运重建（CR）且无心肌梗死（MI）的患者（CR.MI(-)组），6例CR且有MI的患者（CR.MI(+)组），5例不完全血运重建（IR）且无MI的患者（IR.MI(-)组），8例IR且有MI的患者（IR.MI(+)组）。利用放射性核素血管造影术在静息和运动（Ex）期间评估射血分数（EF）、收缩压/收缩末期容积指数（SP/ESVI）和舒张末期容积指数（EDVI）。在CR.MI(-)组中观察到Ex期间SP/ESVI和EF增加，EDVI无变化。在CR.MI(+)组中观察到SP/ESVI增加，EF和EDVI无变化；在IR.MI(-)组中，SP/ESVI、EF和EDVI无变化；在IR.MI(+)组中，观察到SP/ESVI和EDVI无变化，EF降低。CR.MI(-)组的SP/ESVI和EF在4组中分别最高，且在Ex期间与对照组相比无差异。Ex诱导的SP/ESVI增加率与Ex诱导的EF增加（r = 0.81，p小于0.001）和Ex诱导的EFVI增加率（r = 0.54，p小于0.005）呈线性相关。结论是，CR且无MI均可导致Ex期间EF和SP/ESVI正常化。此外，在收缩储备较差的情况下，尽管Ex期间前负荷增加，收缩功能仍可能恶化。
