Liu Chang, Xiu Chun-hong, Xiao Xi-gang, Ni Li-xin, Liu Zong-hong, Wang Bai-chun, Shen Jing-xia, Zhu Kai, Zhang Guo-wei, Xu Lei, Liu Hong-yu
Department of Cardiovascular Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, 150001, The People's Republic of China.
J Clin Ultrasound. 2014 Jan;42(1):9-15. doi: 10.1002/jcu.22045. Epub 2013 Apr 8.
Myocardial functional recovery after revascularization is considered the "gold standard" for myocardial viability (MV) assessment. However, the patency of the revascularized coronary artery affects myocardial functional recovery in patients subjected to coronary artery bypass grafting (CABG). The influence of graft patency on viability results has not been widely studied.
We evaluated the effect of graft patency on the prediction of MV after CABG by myocardial contrast echocardiography (MCE) and low-dose dobutamine stress echocardiography (LD-DSE).
Fifty-three subjects with chronic ischemic heart disease scheduled for CABG were divided randomly into groups A (n = 26) and B (n = 27). They underwent MCE and LD-DSE preoperatively. Patients were followed up 12 months after CABG. Group B patients underwent multislice computed tomography angiography to assess CABG patency, and patients with obstructed grafts were excluded. Group A patients were not subjected to multislice CT angiography. The accuracy of MCE and LD-DSE for assessing MV between the two groups was compared.
The accuracy and positive predictive values of MCE and LD-DSE for predicting MV were higher in group B than in group A (p < 0.05).
Preoperative LD-DSE and MCE ability to predict MV depends on the patency of CABG.
血运重建术后心肌功能恢复被视为评估心肌存活性（MV）的“金标准”。然而，冠状动脉旁路移植术（CABG）患者中，血运重建的冠状动脉通畅情况会影响心肌功能恢复。移植物通畅性对存活性结果的影响尚未得到广泛研究。
我们通过心肌对比超声心动图（MCE）和小剂量多巴酚丁胺负荷超声心动图（LD-DSE）评估了移植物通畅性对CABG术后MV预测的影响。
53例计划行CABG的慢性缺血性心脏病患者被随机分为A组（n = 26）和B组（n = 27）。他们在术前接受了MCE和LD-DSE检查。患者在CABG术后12个月进行随访。B组患者接受多层螺旋CT血管造影以评估CABG通畅情况，移植血管阻塞的患者被排除。A组患者未接受多层CT血管造影。比较两组间MCE和LD-DSE评估MV的准确性。
B组中MCE和LD-DSE预测MV的准确性和阳性预测值高于A组（p < 0.05）。
术前LD-DSE和MCE预测MV的能力取决于CABG的通畅情况。
