Department and Clinic of Cardiac Surgery, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland.
Department and Clinic of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland.
BMC Cardiovasc Disord. 2019 Aug 5;19(1):189. doi: 10.1186/s12872-019-1162-8.
Coronary artery bypass graft (CABG) surgery is an effective therapeutic strategy for coronary heart disease (CHD). Myocardial longitudinal strain echocardiography with 2D speckle tracking could obtain ventricular function with better accuracy and reliability than the left ventricular ejection fraction. The aim of the study was to assess changes in left ventricular function in patients before and after surgical revascularization for a 24-month period of observation, using echocardiography with speckle tracking strain imaging. We searched for echocardiographic predictors of poor early and long-term outcome after CABG.
We enrolled 69 patients scheduled for elective coronary bypass grafting. Patients were divided into groups based on pre-operative systolic and diastolic parameters, depending on the GLS value and the E' Lat and E/E' value. The correlation between these parameters and early and long-term outcomes was analyzed.
Preoperative EF was preserved in 86, 95% (60) patients. Pre-operative reduced GLS was observed in 73.91% (51) of patients and severely reduced in 31.88% (22). In the first post-operative 6-month period, we observed a significant decrease in the GLS. The GLS was a predictor of early postoperative outcome for intubation time, the inotropes use and length of ICU stay. Diastolic dysfunction was a predictor of the greater inotrope requirements.
Global longitudinal strain and diastolic dysfunction parameters are a good predictors of worse early outcome after CABG.
冠状动脉旁路移植术（CABG）是治疗冠心病（CHD）的有效治疗策略。二维斑点追踪应变超声心动图可以比左心室射血分数更准确、更可靠地获得心室功能。本研究旨在通过斑点追踪应变成像评估超声心动图评估手术血运重建后 24 个月的左心室功能变化。我们寻找了 CABG 后早期和长期不良预后的超声心动图预测因子。
我们纳入了 69 例拟行选择性冠状动脉旁路移植术的患者。根据术前收缩和舒张参数，根据 GLS 值和 E' Lat 和 E/E' 值，将患者分为两组。分析这些参数与早期和长期结局的相关性。
86、95%（60）患者术前 EF 正常。73.91%（51）患者术前 GLS 降低，31.88%（22）患者 GLS 严重降低。在术后 6 个月内，我们观察到 GLS 显著下降。GLS 是术后早期拔管时间、正性肌力药物使用和 ICU 住院时间的独立预测因子。舒张功能障碍是正性肌力药物需求增加的预测因子。
整体纵向应变和舒张功能参数是 CABG 后早期预后不良的良好预测因子。
