[左心室功能不全患者冠状动脉搭桥术后早期左心室功能分析]

[Analysis of left ventricular function early after coronary artery bypass grating in patients with left ventricular dysfunction].

作者信息

Sakagoshi M, Hiranaka T, Yagura A

机构信息

Department of Cardiovascular Surgery, Kinan General Hospital, Tanabe, Japan.

出版信息

Kyobu Geka. 1994 Jun;47(6):438-41.

PMID:8207880

Abstract

We analyzed left ventricular (LV) function early after coronary artery bypass grafting (CABG) in patients with LV dysfunction, whose LV ejection fraction (LVEF) was less than 0.4. 11 patients were divided into two groups: Group-A patients (G-A: n = 6) improved LVEF (post-op LVEF > 0.4) and Group-B patients (G-B: n + 5) did not improve LVEF (post-op LVEF < 0.4) one month after CABG. Preoperative status of coronary artery disease, cardiac function, operative procedure, and postoperative cardiac function were compared between two groups. All patient had old myocardial infarction. There were no differences in preoperative LVEF (0.30 +/- 0.06 in G-A and 0.31 +/- 0.06 in G-B), CI, and LVEDP between two groups. LVEDVI (85 +/- 19 in G-A and 159 +/- 50 ml/m2 in G-B) and LVESVI (60 +/- 14 in G-A and 113 +/- 49 ml/m2 in G-B) values were higher in G-B, respectively. Number of grafts was not different between two groups (2.3 in G-A and 2.4 in G-B). Postoperative LVEF value (0.53 +/- 0.07 in G-A and 0.34 +/- 0.04 in G-B) was lower in G-B. Thus, it might be difficult to obtain the recovery of LV function in patients with LV dilatation, early after CABG.

摘要

我们分析了冠状动脉旁路移植术（CABG）后早期左心室（LV）功能，这些患者左心室功能不全，左心室射血分数（LVEF）小于0.4。11例患者分为两组：A组患者（G-A：n = 6）CABG术后1个月LVEF改善（术后LVEF>0.4），B组患者（G-B：n = 5）LVEF未改善（术后LVEF<0.4）。比较两组患者术前冠状动脉疾病状况、心功能、手术操作及术后心功能。所有患者均有陈旧性心肌梗死。两组术前LVEF（G-A组为0.30±0.06，G-B组为0.31±0.06）、心脏指数（CI）和左心室舒张末期压力（LVEDP）无差异。G-B组的左心室舒张末期容积指数（LVEDVI，G-A组为85±19，G-B组为159±50 ml/m2）和左心室收缩末期容积指数（LVESVI，G-A组为60±14，G-B组为113±49 ml/m2）值更高。两组之间的移植血管数量无差异（G-A组为2.3，G-B组为2.4）。G-B组术后LVEF值较低（G-A组为0.53±0.07，G-B组为0.34±0.04）。因此，对于左心室扩张的患者，CABG术后早期可能难以实现左心室功能的恢复。