[MRI study of left ventricular function in patients with coronary disease and myocardial dysfunction before and after coronary revascularization].
OBJECTIVE
To evaluate left ventricular (LV) myocardial function in ten patients with coronary artery disease (CAD) preoperatively and 6 months after coronary bypass grafting (CABG) by cardiac MRI.


METHODS
Ten patients (mean 65.2 +/- 5.9 years) with angiographically proven CAD and an indication for elective CABG underwent prospective evaluation of global LV function and regional wall motion by Cine-MRI at rest using a multiphase FLASH-2D sequence following regions of interest (ROI)-defined diagnostics of regional myocardial wall motion by means of levocardiography. Within the ROIs a total of 613 LV myocardial segments were analyzed preceding and following surgical revascularization. Results were compared with the data of 10 healthy volunteers.


RESULTS
Preoperatively, patients showed reduced stroke volume and ejection fraction compared with volunteers (p < 0.01). Enddiastolic wall thickness (EDWT) and systolic wall thickening (SWT) were significantly lower in the patients (p < 0.01). Based on preoperative levocardiography ROI-defined myocardial segments showed a significantly lower preoperative EDWT in areas with wall motion abnormalities (7.4 +/- 2.5 mm; p < 0.01) than in normal myocardium (9.2 +/- 2.1 mm). Ejection fraction (p < 0.05), endsystolic wall thickness, and SWT (p < 0.01) improved significantly after bypass surgery. On ROI-defined analysis myocardial segments with impaired preoperative wall motion (n = 243) showed a significant increase of EDWT, ESWT and SWT (p < 0.01).


CONCLUSIONS
In patients with CAD, cardiac MRI enables the non-invasive determination of postinfarctional LV remodeling with an increased EDWT of myocardial segments with normal regional wall motion and of the improvement in global and regional myocardial function following coronary bypass surgery.
Juergens
K U
KU
Institut für Klinische Radiologie, Universitätsklinikum Münster. kujuerg@uni-muenster.de
Wichter
T
T
Renger
B
B
Bruns
H J
HJ
Reimer
P
P
Tombach
B
B
Vahlhaus
C
C
Janssen
F W
FW
Breithardt
G
G
Heindel
W
W
D000368:Aged; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods; D008297:Male; D008875:Middle Aged; D017682:Myocardial Stunning / Q000175:diagnosis; D011184:Postoperative Period; D011446:Prospective Studies; D013318:Stroke Volume; D013997:Time Factors; D016277:Ventricular Function, Left