title: Ischemia Index to predict post coronary artery bypass graft change in left ventricular ejection fraction.
abstract: BACKGROUND
  Both myocardial necrosis and ischemia can decrease the left ventricular ejection fraction (LVEF). An accurate estimate of the relative contributions of these irreversible and potentially reversible factors could lead to better decisions regarding the risk and benefit of coronary artery bypass grafting (CABG). The value of an Ischemia Index calculated by subtracting the ECG estimated infarction dependent LVEF from the measured LVEF to predict post-operative improvement of LVEF was studied in 55 patients with LVEF <40% before CABG. Patients were grouped according to absence or presence of other coexisting ECG confounders.
  
  
  RESULTS
  No significant (p=0.083) relationship was found between the Ischemia Index and the improvement in LVEF after CABG in the overall population, but a strong trend was present in the patients with ECGs without confounding QRS changes (p=0.056).
  
  
  CONCLUSIONS
  These results suggest a positive relationship between the Ischemia Index and improvement of LVEF after CABG in patients without electrocardiographic confounders, but a prospective study using a larger sample is needed.
authors.affiliation: Maastricht University, Maastricht, The Netherlands. r.ruth@student.maastrichtuniversity.nl
authors.forename: Rob A J P
authors.initials: RA
authors.lastname: Ruth
authors.forename: Galen S
authors.initials: GS
authors.lastname: Wagner
authors.forename: Mohammed
authors.initials: M
authors.lastname: Soliman Hamad
authors.forename: Jan
authors.initials: J
authors.lastname: Serroyen
authors.forename: Anton P M
authors.initials: AP
authors.lastname: Gorgels
mesh_terms: D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data*; D003936:Diagnosis, Computer-Assisted / Q000379:methods / Q000706:statistics & numerical data*; D004562:Electrocardiography / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D009426:Netherlands / Q000453:epidemiology; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013318:Stroke Volume; D016896:Treatment Outcome