[Impact of left ventricle remodeling on perioperative risk and short-term prognosis in patients with heart failure and reduced ejection fraction undergoing coronary artery bypass grafting].

To explore the impact of left ventricle remodeling on perioperative risk and short-term survival in patients with heart failure and reduced ejection fraction (HFrEF) undergoing coronary artery bypass grafting (CABG). A total of 78 coronary artery disease (CAD) patients (54 males, 24 females) with symptoms and signs of heart failure and a left ventricular ejection fraction (LVEF)<40% were consecutively enrolled from January 2014 to December 2018 in Beijing Anzhen Hospital. The average age was (59±8) years old. Transthoracic echocardiography was performed to measure LVEF and left ventricle end-systolic volume index (LVESVI) during hospitalization, and the average LVESVI was (92±18) ml/m(2). According to the mean value of LVESVI, the patients were divided into 2 groups: mild left ventricle remodeling group (group M, 46, LVESVI<92 ml/m(2)) and severe left ventricle remodeling group (group S, 32, LVESVI≥92 ml/m(2)). The follow-up period was (30±12) months. Operative mortality, perioperative complications and long-term survival were compared between the two groups. Perioperative mortality was 5.1% (4/78), which was significantly higher in group S than that of group M (9.4% vs 2.2%, 0.03). The proportion of patients with intra-aortic balloon pump (IABP) was higher in group S than that of group M during the perioperative period (62.5% vs 36.9%, 0.01). Compared with patients in group M, those with severe left ventricle remodeling were more susceptible to atrial fibrillation after surgery (25.0% vs 6.5%, 0.02). The mean follow-up time was (30±12) months. There was no difference in major adverse cardiac event (MACE)-free survival in 12 month, 24 month and 36 month between the two groups (100% vs 100%, 87.9% vs 92.1%, 80.3% vs 78.3%, 0.68). Left ventricular remodeling increases the perioperative mortality and complications of patients with ischemic HFrEF undergoing CABG, but it has no impact on short-term survival.