Noninvasive assessment of the effects of aorta-coronary bypass grafting on ventricular function during rest and exercise.

Ventricular function was measured by radionuclide angiocardiography during rest and exercise in patients before and approximately 4 months after aorta-coronary bypass grafting. The first group of seven patients continued to have symptomatic chest pain after operation. The second group of 13 patients were asymptomatic after operation but, since they had been studied before operation, consented to postoperative study. Before operation, both patient groups demonstrated similar degrees of myocardial ischemia during exercise as documented by a decrease in ejection fraction, by large increases in end-diastolic and end-systolic volumes, and by exercise-induced wall motion abnormalities. After aorta-coronary bypass grafting, ventricular function in the symptomatic patients was unchanged during rest and exercise. In contrast, ventricular function during rest and exercise in the asymptomatic patients was markedly improved. With exercise, the ejection fraction increased and the exercise-induced wall motion abnormalities seen before operation were abolished. Therefore, aorta-coronary bypass grafting can effectively reverse exercise-induced left ventricular dysfunction in patients with coronary disease. Moreover, the change in left ventricular function demonstrated by radionuclide angiocardiography correlated with the clinical status of the patient groups.