Related Experiment Video
Updated: Aug 8, 2026
Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
Published on: September 15, 2023
Biventricular diastolic filling patterns after coronary artery bypass graft surgery
Yanfen Shi1, André Y Denault, Pierre Couture
1Department of Medicine, Montreal Heart Institute, and University of Montreal, Montreal, Quebec, Canada.
Insights
Biventricular filling patterns worsen after coronary artery bypass grafting but recover within six months. This study tracked diastolic function in patients with pre-existing left ventricular diastolic dysfunction.
Area of Science:
- Cardiology
- Cardiac Surgery
- Echocardiography
Background:
- Diastolic dysfunction is common in patients undergoing coronary artery bypass grafting (CABG).
- The impact of CABG on biventricular diastolic function, particularly in those with pre-existing left ventricular diastolic dysfunction, remains incompletely understood.
- Novel echocardiographic methods are crucial for assessing diastolic function changes post-CABG.
Purpose of the Study:
- To investigate the temporal changes in biventricular filling properties following coronary artery bypass grafting.
- To evaluate the recovery of diastolic function in patients with preoperative left ventricular diastolic dysfunction after CABG.
Main Methods:
- Transthoracic echocardiography was performed preoperatively, 48 hours post-CABG, and at 6 months post-CABG.
- The study included 49 patients with preoperative left ventricular diastolic dysfunction, randomized to milrinone or placebo.
- Diastolic dysfunction was assessed using established criteria for both left and right ventricles, including Doppler and tissue Doppler imaging parameters.
Main Results:
- Left ventricular diastolic dysfunction (moderate and severe) significantly increased from 8.2% to 53.7% and 2.0% to 9.7%, respectively, at 48 hours post-CABG (P < .0001).
- Right ventricular diastolic dysfunction showed a similar worsening trend over the same period.
- By 6 months post-CABG, biventricular filling patterns returned to their preoperative status.
Conclusions:
- Coronary artery bypass grafting initially impairs biventricular filling patterns in patients with preoperative diastolic dysfunction.
- Diastolic function demonstrates significant recovery, returning to baseline preoperative levels by 6 months after CABG.
- These findings highlight the transient nature of post-CABG diastolic dysfunction in this patient cohort.
Objective:
We sought to study the evolution of biventricular filling properties after coronary artery bypass grafting.
Background:
The evolution of diastolic function as defined with newer echocardiographic modalities after coronary artery bypass grafting surgery is unknown in patients with preoperative left ventricular diastolic dysfunction.
Methods:
Transthoracic echocardiography was performed preoperatively and 48 hours and 6 months after coronary artery bypass grafting in 49 patients (randomized to milrinone [n = 25]) or placebo [n = 24]) with preoperative left ventricular diastolic dysfunction classified according to published criteria. Mild right ventricular diastolic dysfunction was defined as the ratio of early to atrial filling velocity of less than 1 in transtricuspid flow or the velocity of reversed atrial flow of greater than 50% of that of systolic flow in hepatic venous flow or the ratio of tricuspid annulus velocity during early and atrial filling of less than 1 if both the ratio of early to atrial filling velocity and the ratio of systolic to diastolic velocity was greater than 1 in hepatic venous flow. Moderate right ventricular diastolic dysfunction was diagnosed when there was a ratio of early to atrial filling velocity of greater than 1 with a ratio of systolic to diastolic velocity of less than 1. Severe right ventricular diastolic dysfunction was defined as a ratio of early to atrial filling velocity of greater than 1 associated with reversed systolic wave in hepatic venous flow.
Results:
Moderate and severe left ventricular diastolic dysfunction increased from preoperatively to 48 hours after coronary artery bypass grafting from 8.2% to 53.7% and from 2.0% to 9.7%, respectively (P < .0001, 48 hours vs preoperatively for both), and the patterns at 6 months were similar to those observed preoperatively. Similar evolution over time was found for right ventricular diastolic dysfunction.
Conclusions:
In patients with preoperative left ventricular diastolic dysfunction, biventricular filling patterns are impaired initially but return to preoperative status 6 months after coronary artery bypass grafting.
