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In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
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Left ventricular end-systolic volume index in patients with ischemic cardiomyopathy predicts postoperative

A Yamaguchi1, T Ino, H Adachi

  • 1Department of Cardiovascular Surgery, Jichi Medical School, Omiya Medical Center, Saitama, Japan.

The Annals of Thoracic Surgery
|October 1, 1995
PubMed

Insights

Preoperative left ventricular end-systolic volume index (LVESVI) predicts recovery of heart function after bypass surgery. A lower LVESVI (<100 mL/m2) indicates better outcomes in ischemic cardiomyopathy patients.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Cardiovascular Imaging

Background:

  • Assessing postoperative ventricular function is crucial for patients undergoing coronary artery bypass grafting (CABG).
  • Preoperative left ventricular end-systolic volume index (LVESVI) is explored as a potential predictor of cardiac recovery.
  • Ischemic cardiomyopathy with low ejection fraction presents a challenge for surgical outcomes.

Purpose of the Study:

  • To evaluate the predictive value of preoperative LVESVI for postoperative ventricular function.
  • To determine if LVESVI can identify patients likely to benefit from CABG despite severely impaired ejection fraction.

Main Methods:

  • Retrospective review of 310 CABG patients, identifying 20 with ischemic cardiomyopathy (ejection fraction <0.30).
  • Measurement of preoperative and postoperative ejection fraction and LVESVI using biplane cineventriculography.
  • Group division based on preoperative LVESVI: <100 mL/m2 (Group A) and >100 mL/m2 (Group B).

Main Results:

  • Group A showed a significant increase in ejection fraction (0.25 to 0.40) and decrease in LVESVI (83.2 to 61.7 mL/m2) post-CABG.
  • Group B demonstrated no significant change in ejection fraction or LVESVI.
  • Four patients in Group B required rehospitalization for congestive heart failure.

Conclusions:

  • Patients with preoperative LVESVI <100 mL/m2 experience significant improvement in ejection fraction after CABG.
  • Preoperative LVESVI is a valuable predictor of postoperative ventricular function and patient outcomes in ischemic cardiomyopathy.
  • LVESVI stratification can aid in surgical decision-making for patients with reduced ejection fraction.
Abstract

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