Comparison of cardiovascular magnetic resonance of late gadolinium enhancement and diastolic wall thickness to predict recovery of left ventricular function after coronary artery bypass surgery.
BACKGROUND
The objective was to compare the value of late gadolinium enhancement (LGE) and end-diastolic wall thickness (EDWT) assessed by cardiovascular magnetic resonance (CMR) in predicting recovery of left ventricular function after coronary artery bypass surgery (CABG).


METHODS
We enrolled patients with coronary artery disease and left ventricular ejection fraction < 45% who were scheduled for CABG. Regional contractility was assessed by cine CMR at baseline and 4 months after CABG. EDWT and LGE were assessed at baseline. Predictors for improvement of regional contractility were analyzed.


RESULTS
We studied 46 men and 4 women with an average age of 61 years. Baseline left ventricular ejection fraction was 37 +/- 13%. A total of 2,020 myocardial segments were analyzed. Abnormal wall motion and the LGE area were detected in 1,446 segments (71.6%) and 1,196 segments (59.2%) respectively. Wall motion improvement was demonstrated in 481 of 1,227 segments (39.2%) that initially had wall motion abnormalities at baseline. Logistic regression analysis showed that the LGE area, EDWT and resting wall motion grade predicted wall motion improvement. Comparison of Receiver-Operator-Characteristic (ROC) curves demonstrated that the LGE area was the most important predictor (p < 0.001). Adding information from LGE to the EDWT can decrease the number of false predictions by EDWT alone from 483 to 127 segments.


CONCLUSIONS
LGE and EDWT are independent predictors for functional recovery after revascularization. However, LGE appears to be a more important factor and independent of EDWT.
Krittayaphong
Rungroj
R
Department of Medicine, Division of Cardiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. sirkt@mahidol.ac.th
Laksanabunsong
Pansak
P
Maneesai
Adisak
A
Saiviroonporn
Pairash
P
Udompunturak
Suthipol
S
Chaithiraphan
Vithaya
V
D000328:Adult; D000368:Aged; D003287:Contrast Media; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D019786:Gadolinium DTPA; D006352:Heart Ventricles / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D007089:Image Enhancement; D016015:Logistic Models; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D011237:Predictive Value of Tests; D012372:ROC Curve; D020127:Recovery of Function; D013318:Stroke Volume; D016896:Treatment Outcome; D016277:Ventricular Function, Left
D003287:Contrast Media; D019786:Gadolinium DTPA