title: Coronary artery bypass surgery in heart failure patients with chronic reversible and irreversible myocardial dysfunction: effect on heart rate variability.
abstract: It is unknown whether surgical revascularization of viable and chronic reversibly dysfunctional myocardium in patients with heart failure is associated with a favorable effect on the autonomic control of heart rate. We studied 38 coronary artery bypass surgery (CABG) patients with an ejection fraction of 36 +/- 7%. Before CABG, the patients underwent 48-hour ambulatory electrocardiographic monitoring to measure heart rate variability (HRV), echocardiography to assess left ventricular function, and positron emission tomography and low-dose dobutamine echocardiography to assess viability. Six months after CABG, ambulatory electrocardiographic monitoring and echocardiography were repeated to assess HRV and recovery of left ventricular function. In spite of viable myocardium and recovery of left ventricular function following CABG, HRV indices were reduced 6 months postoperatively. A potential prognostic benefit gained by revascularizing patients with viability may occur in spite of deteriorated autonomic control of heart rate.
authors.affiliation: Department of Cardiology, Skejby Hospital, Aarhus University Hospital, Aarhus, Denmark. henrikwiggers@dadlnet.dk
authors.forename: Henrik
authors.initials: H
authors.lastname: Wiggers
authors.forename: Hans Erik
authors.initials: HE
authors.lastname: Bøtker
authors.forename: Henrik
authors.initials: H
authors.lastname: Egeblad
authors.forename: Evald Høj
authors.initials: EH
authors.lastname: Christiansen
authors.forename: Torsten Toftegaard
authors.initials: TT
authors.lastname: Nielsen
authors.forename: Henning
authors.initials: H
authors.lastname: Mølgaard
mesh_terms: D000368:Aged; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery; D002908:Chronic Disease; D001026:Coronary Artery Bypass; D025401:Echocardiography, Stress; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care; D020127:Recovery of Function / Q000502:physiology; D013997:Time Factors; D014055:Tomography, Emission-Computed; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology