Perioperative tissue Doppler echocardiography and bypass graft flowmetry in patients undergoing coronary revascularization: predictive power for late recovery of regional myocardial function.
To assess if recovery of regional myocardial function can be predicted by perioperative Doppler tissue echocariography, 20 patients undergoing coronary artery bypass graft surgery (mean 4.1 grafts) had serial transthoracic and transesophageal echocardiography. Systolic velocities were lower in basal posterior and anterior segments, and higher in the midanterior septum, at intraoperative transesophageal echocardiography compared with preoperative transthoracic echocardiography (-45%, -30%, +18%, respectively), but comparable elsewhere. After bypass, velocities were increased in midposterior, basal lateral, basal anterior, and midanterior septal segments (+41%, 25%, 27%, 44%, respectively, P <.05). Increased velocities in circumflex segments at 6 weeks (midposterior, basal lateral, and midlateral +54%, 45%, 39%, respectively, P <.05) were not predicted by perioperative changes or related to graft flow (transit-time flowmetry; R -0.09, -0.14, and -0.32, respectively, not significant). Myocardial velocities measured by transthoracic and transesophageal echocardiography are not comparable in segments with different angles of insonation. Perioperative changes in resting myocardial systolic velocity are highly variable and do not predict late recovery.
Williams
R Ian
RI
Cardiovascular Sciences Research Group, University of Wales College of Medicine, Cardiff, UK.
Haaverstad
Rune
R
Sianos
Georgios
G
Vourvouri
Eleni
E
Fraser
Alan G
AG
D000368:Aged; D001158:Arteries / Q000503:physiopathology / Q000601:surgery; D001783:Blood Flow Velocity / Q000502:physiology; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D003331:Coronary Vessels / Q000503:physiopathology / Q000601:surgery; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D009204:Myocardial Revascularization; D019990:Perioperative Care; D011237:Predictive Value of Tests; D011300:Preoperative Care; D020127:Recovery of Function / Q000502:physiology; D012212:Rheology; D013599:Systole / Q000502:physiology; D013997:Time Factors; D016896:Treatment Outcome