Prognostic value of pseudonormal and restrictive filling patterns on left ventricular remodeling and cardiac events after coronary artery bypass grafting.
This study was aimed to assess the prognostic value of transmitral flow (TMF) patterns on patients after coronary artery bypass grafting (CABG). TMF, left ventricular (LV) end-diastolic diameter (LVDd) and LV ejection fraction (LVEF) were studied in 102 patients before and after CABG by echocardiography. Patients were subdivided into 4 groups according to TMF patterns during hospital stay shortly after CABG; group 1 (n = 37) had normal filling patterns; group 2 (n = 29) had abnormal relaxation patterns; group 3 (n = 24) had pseudonormal patterns; and group 4 (n = 12) had restrictive patterns. One year after CABG, LVDd was greater and LVEF was lower in groups 3 and 4 than in groups 1 and 2, although there were no significant differences in LVDd and LVEF among the 4 groups before and shortly after CABG. During the follow-up period of 29 +/- 20 months, 19 patients had cardiac events. The incidence of cardiac events in groups 3 and 4 determined by the Kaplan-Meier method was significantly higher than that in groups 1 and 2 (Mantel-Cox test, p <0.01). Patients' gender, clinical findings, and echocardiographic variables were compared for their ability to predict cardiac events by means of the Cox proportional hazards model, and only the LVDd and TMF patterns during the hospital stay after CABG were recognized as independent predictors of cardiac events (chi-square 4.9 and 11.3, respectively; p <0.05). Pseudonormal or restrictive TMF patterns during hospital stay shortly after CABG are useful indicators for predicting outcome.
Liu
Jinyao
J
Department of Cardiovascular Medicine, Yamaguchi University School of Medicine, Ube, Japan.
Tanaka
Nobuaki
N
Murata
Kazuya
K
Ueda
Kayo
K
Wada
Yasuaki
Y
Oyama
Rikimaru
R
Matsuzaki
Masunori
M
D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D015150:Echocardiography, Doppler / Q000379:methods*; D005069:Evaluation Studies as Topic; D005260:Female; D006334:Heart Function Tests; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011336:Probability; D011379:Prognosis; D016016:Proportional Hazards Models; D012494:Sampling Studies; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*; D020257:Ventricular Remodeling