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Coronary artery bypass surgery in heart failure patients with chronic reversible and irreversible myocardial

Henrik Wiggers1, Hans Erik Bøtker, Henrik Egeblad

  • 1Department of Cardiology, Skejby Hospital, Aarhus University Hospital, Aarhus, Denmark. henrikwiggers@dadlnet.dk

Cardiology
|February 5, 2003
PubMed

Insights

Coronary artery bypass surgery (CABG) in heart failure patients with viable myocardium did not improve heart rate variability (HRV) 6 months post-surgery. Prognostic benefits may exist despite worsened autonomic control after CABG.

Area of Science:

  • Cardiology
  • Autonomic Nervous System Research
  • Cardiac Surgery

Background:

  • Heart failure (HF) patients often have impaired autonomic control of heart rate.
  • Surgical revascularization aims to improve cardiac function, but its effect on autonomic control is unclear.
  • Assessing autonomic function via heart rate variability (HRV) is crucial in HF management.

Purpose of the Study:

  • To investigate the impact of coronary artery bypass surgery (CABG) on heart rate variability (HRV) in heart failure patients with viable myocardium.
  • To determine if surgical revascularization favorably affects autonomic control of heart rate in this population.

Main Methods:

  • 38 heart failure patients with ejection fraction 36±7% underwent 48-hour ambulatory ECG monitoring for HRV, echocardiography for left ventricular function, and viability assessment (PET/dobutamine echo) before CABG.
  • These assessments were repeated 6 months after CABG.

Main Results:

  • Despite viable myocardium and recovery of left ventricular function post-CABG, HRV indices were significantly reduced at 6 months.
  • No improvement in autonomic control of heart rate was observed after surgical revascularization.

Conclusions:

  • Surgical revascularization in heart failure patients with viable myocardium may not improve, and could even worsen, autonomic control of heart rate.
  • The prognostic benefit of CABG in these patients might be achieved despite a deterioration in heart rate variability.

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