Tchervenkov C I, Symes J F, Sniderman A D, Lisbona R, Derbekyan V A, Novick R J, Wynands J E, Dobell A R, Morin J E
Ann Thorac Surg. 1985 Apr;39(4):340-5. doi: 10.1016/s0003-4975(10)62627-6.
To assess the changes in resting left ventricular (LV) function following coronary bypass surgery, technetium 99m-labeled multiple equilibrated blood pool gated scans were performed in 53 consecutive patients at rest, before operation, and at 24 hours and 1 week after operation. Left ventricular ejection fraction (LVEF) and end-diastolic volume (EDV) were measured. The LVEF increased significantly from a preoperative value of 49 +/- 2% to 56 +/- 2% at 24 hours after operation (p less than 0.05) and 56 +/- 2% at 1 week following operation (p less than 0.05 compared with the preoperative value). The EDV also exhibited significant changes, decreasing from a preoperative value of 148 +/- 8 ml to 91 +/- 11 ml at 24 hours (p less than 0.001) and 114 +/- 9 ml at 1 week (p less than 0.01 compared with the preoperative value). When the patients were divided into two groups according to the preoperative LVEF (Group 1, LVEF of greater than or equal to 50%; Group 2, LVEF of less than 50%), the observed changes were similar. This study demonstrates significant improvement in resting LV function 24 hours following coronary bypass surgery. This improvement persists at 1 week and is not related to the degree of preoperative impairment. We conclude that the combination of successful revascularization and optimal myocardial protection can result in significant improvement of LV function at rest.
为评估冠状动脉搭桥手术后静息状态下左心室(LV)功能的变化,对53例连续患者在术前静息状态下、术后24小时及术后1周进行了锝99m标记的多平衡血池门控扫描。测量左心室射血分数(LVEF)和舒张末期容积(EDV)。LVEF从术前的49±2%显著增加至术后24小时的56±2%(p<0.05)以及术后1周的56±2%(与术前值相比p<0.05)。EDV也呈现出显著变化,从术前的148±8 ml降至术后24小时的91±11 ml(p<0.001)以及术后1周的114±9 ml(与术前值相比p<0.01)。当根据术前LVEF将患者分为两组时(第1组,LVEF大于或等于50%;第2组,LVEF小于50%),观察到的变化相似。本研究表明冠状动脉搭桥手术后24小时静息LV功能有显著改善。这种改善在1周时持续存在,且与术前受损程度无关。我们得出结论,成功的血运重建与最佳的心肌保护相结合可导致静息状态下LV功能显著改善。