title: Right ventricular function before and after an uncomplicated coronary artery bypass graft as assessed by pulsed wave Doppler tissue imaging of the tricuspid annulus.
abstract: BACKGROUND
  Right ventricular (RV) function using myocardial velocities before and after a coronary artery bypass graft (CABG) is not known.
  
  
  METHODS
  Using pulsed wave Doppler tissue imaging, RV function was studied in 35 patients before and after CABG. Patients were followed-up for 1 year after the CABG. Myocardial velocities at the tricuspid annulus at the RV free wall were recorded from the apical 4-chamber views.
  
  
  RESULTS
  Both the systolic and early diastolic tricuspid annular velocities (TAV) were significantly reduced 1 month after CABG (P <.001 for both). During the follow-up period, there was no improvement in the diastolic TAV. The systolic TAV showed no improvement 3 months after CABG but recovered partially 1 year after the CABG (systolic velocities were 11.8, 8.7, 8.7 and 9.7 cm/s, the early diastolic velocities were 11.0, 8.1, 8.1 and 8.2 cm/s before and 1 month, 3 months and 1 year after the CABG, respectively). The systolic and early diastolic velocities of the interventricular septum were unchanged during the follow-up period. Unlike the right ventricle, the mitral annular systolic velocity was unchanged shortly after CABG and showed signs of improvement after 1 year (6.4, 6.9, 6.8 and 7.3 cm/s respectively before and after CABG). Patients underwent dobutamine stress echocardiography (DSE) before and 3 months after the CABG. The systolic TAV increased significantly during the DSE before CABG (11.8 vs 15.8 cm/s, P <.001). However, the increase in systolic TAV was limited during DSE 3 months after CABG (8.7 vs 9.9 cm/s, P <.05).
  
  
  CONCLUSIONS
  RV function, as assessed by TAV, decreased significantly after CABG and the changes were still evident after 1 year. The response of systolic TAV during DSE was more pronounced before CABG than after CABG.
authors.affiliation: Department of Cardiology, Karolinska Institute at Söder Hospital (Södersjukhuset), Stockholm, Sweden. mahbubul.alam@medklin.sos.sll.se
authors.forename: Mahbubul
authors.initials: M
authors.lastname: Alam
authors.forename: Anders
authors.initials: A
authors.lastname: Hedman
authors.forename: Rolf
authors.initials: R
authors.lastname: Nordlander
authors.forename: Bassem
authors.initials: B
authors.lastname: Samad
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D016022:Case-Control Studies; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000503:physiopathology / Q000628:therapy*; D018619:Echocardiography, Doppler, Pulsed; D025401:Echocardiography, Stress; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000502:physiology; D011446:Prospective Studies; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000503:physiopathology*; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016278:Ventricular Function, Right / Q000502:physiology*