Prediction of contractile reversibility in impaired left ventricular wall motion following coronary artery bypass grafting.
Interventional left vertriculograms (LVGs) using postextrasystolic potentiation (PESP), nitroglycerin (TNG) and a combination of both were analyzed in order to decide the degree of efficacy of each intervention as a predictor of reversibility in impaired left ventricular segments. Segmental wall motion (SWM) in less severely impaired segments increased to the normal range and SWM in severely impaired segments increased but remained in the abnormal range after CABG. The effects of both PESP and TNG on SWM in impaired segments correlated (r = 0.78 and 0.78) with that of CABG. The increase in SWM due to TNG + PESP was significantly (p < 0.01) greater than that due to either PESP or TNG alone or that of CABG. Either PESP or TNG was clinically reliable for prediction of contractile reversibility in the segments with impaired wall motion prior to CABG. Including the global left ventricular function, PESP reflected the efficacy of CABG more sufficiently than TNG. TNG + PESP provoked more contractile reserve and exaggerated the results of CABG, but may predict reversibility in severely reduced wall motion.
Department of Circulatory Dynamics, Center for Adult Diseases, Osaka, Japan.
T
T
Kobayashi
Y
Y
Fudemoto
T
T
Yoshino
T
T
Oda
K
K
Fujimoto
H
H
Hirose
Y
Y
Kawashima
D000328:Adult; D001026:Coronary Artery Bypass; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement; D009200:Myocardial Contraction; D005996:Nitroglycerin / Q000627:therapeutic use*; D011859:Radiography; D016896:Treatment Outcome; D016277:Ventricular Function, Left
D005996:Nitroglycerin