[Regional ventricular function at rest during exercise before and after bypass surgery (author's transl)].

Area of Science:

• Cardiology
• Cardiac Surgery
• Cardiovascular Physiology

Context:

• Coronary heart disease (CHD) significantly impairs left ventricular function, leading to reduced contractility and exercise intolerance.
• Aortocoronary bypass surgery is a common intervention aimed at restoring myocardial perfusion and improving cardiac performance in CHD patients.
• Preoperative assessment of ventricular function is crucial for evaluating surgical outcomes and patient prognosis.

Purpose:

• To evaluate the impact of aortocoronary bypass surgery on isovolumetric contractility indices and ejection phase parameters in patients with coronary heart disease.
• To assess regional and global left ventricular function at rest and during physiological stress (leg raising, exercise) before and after bypass surgery.
• To correlate graft patency with functional recovery and symptom relief in patients undergoing coronary artery bypass grafting.

Summary:

• In patients with coronary heart disease, preoperative assessment revealed impaired left ventricular function, characterized by increased left ventricular end-diastolic pressure (LVEDP) and reduced velocity of fiber shortening, especially during exercise.
• Five weeks after aortocoronary bypass surgery, patients with patent grafts demonstrated significant improvements in ventricular contractility and ejection fraction, with enhanced regional wall motion during leg raising and exercise.
• Patients with occluded grafts or intraoperative complications showed no significant functional improvement compared to preoperative values, highlighting the importance of successful revascularization.

Impact:

• Successful aortocoronary bypass surgery markedly improves cardiac function, enabling patients to tolerate physical exercise without angina and significantly enhancing ejection fraction and contractility.
• The study demonstrates a substantial functional recovery, with improvements up to 500% in individual wall segments, underscoring the efficacy of surgical revascularization in CHD.
• These findings provide critical evidence for the benefits of bypass surgery in restoring myocardial function and improving the quality of life for patients with coronary heart disease.