Baseline characteristics and 1-year outcome by left ventricular function in the CABG PREFERS
Ulrika Löfström1,2, Cecilia Linde2,3, Maria J Eriksson4,5
1Department of Cardiology, Capio St. Görans Hospital, Sankt Göransplan 1, SE-112 81 Stockholm, Sweden.
European Heart Journal Open
|April 3, 2025
Summary
Elective coronary artery bypass grafting (CABG) patients often have left ventricular (LV) dysfunction. Unexpectedly, those with normal LV function at baseline showed worsening cardiac and kidney function one year post-CABG.
Area of Science:
- Cardiology
- Cardiac Surgery
- Echocardiography
Background:
- Left ventricular (LV) dysfunction is a critical factor in patients undergoing coronary artery bypass grafting (CABG).
- Phenotyping patients based on LV function (preserved ejection fraction [pEF], reduced ejection fraction [rEF], and normal) is essential for understanding outcomes.
- The CABG PREFERS cohort study prospectively examines these phenotypes.
Purpose of the Study:
- To characterize patients undergoing elective CABG based on baseline and 1-year LV function.
- To investigate changes in cardiac function, biomarkers, and kidney function across different LV function phenotypes post-CABG.
Main Methods:
- Prospective, single-center cohort study (CABG PREFERS).
- Classification of 136 elective CABG patients into pEF, rEF, and normal LV function groups using echocardiography and NT-proBNP.
- Assessment at baseline and 1-year follow-up included ECG, echocardiography, cardiac MRI, lab tests, and quality of life.
Main Results:
- 45% of patients exhibited LV dysfunction (25% pEF, 20% rEF).
- Patients with normal LV function showed significant deterioration in E/é (7.8-8.9), NT-proBNP (150-182 ng/L), and eGFR (82.5-78.9 mL/min/1.73 m²) at 1-year.
- Improvements in echocardiographic parameters were observed in pEF and rEF groups.
Conclusions:
- LV dysfunction is prevalent in elective CABG patients.
- Patients with initially normal LV function experienced adverse changes in systolic/diastolic function, NT-proBNP, and eGFR one year post-surgery.
- Further research is needed to understand the implications of these findings for long-term outcomes.
Related Concept Videos
01:28Cardiac Catheterization I: Pre-Procedure Overview
Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
01:24Cardiac Catheterization III: Left Heart Catheterization
Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
01:30Heart Failure IV: Classification and Diagnostic Evaluation
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
01:30Cardiomyopathy II: Dilated Cardiomyopathy
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
01:29Cardiomyopathy V: Interprofessional Care
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...