Myocardial perfusion correlates with improvement of systolic function of the left ventricle after CABG. Dobutamine echocardiography and Tc-99m-MIBI SPECT study.
OBJECTIVE
The aim of the study was to assess the effect of surgical revascularization [coronary artery bypass grafting (CABG)] on systolic function and perfusion of the left ventricle using dobutamine echocardiography (DE) and Tc-99m-MIBI SPECT (SPECT).


METHODS
There were 32 patients mean age 52.2+/-7.2 years in whom DE and SPECT were performed before and 3-4 months after CABG using standard protocols. Wall motion score index (WMSI) and perfusion index (PI) were calculated.


RESULTS
Significant improvement of WMSI at rest (1.44+/-0.46 vs 1.33+/-0.41; P=0.03) as well as after maximal dose of dobutamine (1.49+/-0.42 vs 1.39+/-0.44; P=0.02) was observed after CABG as compared to preoperative examination. Similar relation was observed during SPECT study. Perfusion index diminished significantly after revascularization during rest acquisition (2.19+/-0.71 vs 1.93+/-0.70; P=0.0008) and after Dipirydamole administration (2.73+/-0.73 vs 2.20+/-0.69; P=0.0001) as compared to preoperative examination. We found correlation between PI and WMSI at rest before CABG (R=0.46; P=0.01), PI after Dipirydamole and WMSI after maximal dose of Dobutamine before CABG (R=0.37; P=0.04), PI and WMSI at rest after CABG (R=0.39; P=0.03), PI after Dipirydamole and WMSI after dobutamine after CABG (R=0.38; P=0.03).


CONCLUSIONS
Surgical revascularization significantly improves both perfusion and contractility. Increased perfusion after CABG correlates with improvement of systolic function of the left ventricle.
Paluszkiewicz
L
L
Department of Cardiac Surgery, Institute of Cardiology, 61-848 Poznań ul. Dluga 1/2, Poland. lpalusz@poczta.onet.pl
Kwinecki
P
P
Jemielity
M
M
Szyszka
A
A
Dyszkiewicz
W
W
Cieśliński
A
A
D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D004280:Dobutamine; D005080:Exercise Test; D006801:Humans; D008875:Middle Aged; D015425:Myocardial Reperfusion; D019275:Radiopharmaceuticals; D013599:Systole; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon; D014463:Ultrasonography; D016277:Ventricular Function, Left
D019275:Radiopharmaceuticals; D004280:Dobutamine; D017256:Technetium Tc 99m Sestamibi