Shearn D L, Brent B N
Am J Med. 1986 Mar;80(3):405-11. doi: 10.1016/0002-9343(86)90714-x.
The effects of coronary artery bypass surgery in patients with left ventricular dysfunction (left ventricular ejection fraction of less than 45 percent) on survival, symptoms, left ventricular ejection fraction, and regional left ventricular function were prospectively assessed in 34 patients. Left ventricular function was serially assessed by nuclear angiocardiography. Operative mortality was 9 percent, and mortality during the follow-up period was 10 percent. Twenty of 21 patients with class III or IV anginal symptoms preoperatively improved by at least two functional classes. Seven of 10 patients with class III or IV symptoms of heart failure preoperatively improved by at least one functional class. Global left ventricular ejection fraction improved significantly with surgery (p less than 0.05). Regional left ventricular systolic function improved as well (p less than 0.005). These findings suggest that in selected patients with left ventricular dysfunction, coronary artery bypass surgery can be performed with acceptable mortality and may result in symptomatic and functional benefit.
前瞻性评估了34例左心室功能不全（左心室射血分数小于45%）患者接受冠状动脉搭桥手术后的生存情况、症状、左心室射血分数和左心室局部功能。通过核素心血管造影术对左心室功能进行连续评估。手术死亡率为9%，随访期间死亡率为10%。21例术前有Ⅲ或Ⅳ级心绞痛症状的患者中有20例功能分级至少改善了两级。10例术前有Ⅲ或Ⅳ级心力衰竭症状的患者中有7例功能分级至少改善了一级。手术使整体左心室射血分数显著提高（p<0.05）。左心室局部收缩功能也有所改善（p<0.005）。这些发现表明，对于选定的左心室功能不全患者，冠状动脉搭桥手术可以在可接受的死亡率下进行，并可能带来症状和功能改善。
