Complete Revascularization Showed A Better Cardiac Function Improvement In Patients With Low Ejection Fraction

Area of Science:

• Cardiology
• Cardiac Surgery

Background:

• Coronary artery bypass grafting (CABG) is a common surgical intervention for coronary artery disease.
• Preoperative left ventricle ejection fraction (EF) is a crucial indicator of cardiac function and prognosis.
• The impact of preoperative EF on postoperative outcomes after CABG warrants further investigation.

Purpose of the Study:

• To compare the postoperative ejection fraction (EF) changes in patients undergoing elective on-pump CABG.
• To analyze outcomes based on preoperative left ventricle EF, specifically comparing groups with EF <35% and EF >35%.

Main Methods:

• A retrospective study of 660 patients undergoing elective on-pump CABG between 2018-2019.
• Patients were stratified into two groups: preoperative EF <35% (Group A, n=72) and EF >35% (Group B, n=588).
• The primary endpoint was the change in EF from pre- to postoperative measurements.

Main Results:

• Both groups showed no significant difference in cardiopulmonary bypass (CPB) and aortic clamp (AxC) durations.
• A significant difference in EF transformation was observed between Group A (2.91+10.31) and Group B (-0.14+4.57) (P < 0.001).
• Group A experienced significantly longer ICU stays and required more postoperative ventilatory support compared to Group B.

Conclusions:

• Patients with lower preoperative EF (<35%) demonstrated a greater improvement in cardiac function post-CABG.
• The observed improvement may be attributed to the revascularization of hibernating myocardium.
• This finding suggests that CABG can be beneficial for improving cardiac function in patients with severely reduced EF.