The Impact of Coronary Artery Bypass Grafting on Left Ventricular Functions and Mechanical Dyssynchrony

Abstract

Introduction: The wide spectrum of coronary artery diseases (CAD) ranging from stable ischemic heart disease (SIHD) to acute coronary syndrome (ACS) is considered a major cause of death and disability worldwide. Aim of the Work: The aim of this study is to assess the impact of coronary artery bypass grafting on left ventricular functions and mechanical dyssynchrony using color coded tissue Doppler imaging. Patients and Methods: This study was conducted on 58 consecutive patients with ischemic heart disease who were electively referred to perform CABG, in the period between March 2015 to March 2016 at Ain Shams University Hospitals and at Nasr City Insurance Hospital. Results: Initially 58 patients were screened however the study was performed on 44 patients with ischemic heart disease in the period between March 2015 and March 2016 who were referred to Ain-Shams University Hospitals and to Nasr City Health Insurance Hospital for elective CABG surgery. Conclusions: Surgical revascularization significantly reduced Ts-SD. The 3 indices of dyssynchrony namely Ts-SD, Ts difference and BSPLWMD were correlated to each other however none of them correlated to EF. Hypertensive patients showed significantly higher levels of dyssynchrony compared to non- hypertensive patients both at baseline and at follow up and showed greater benefit from surgery compared to non-hypertensive group. Recommendations: Larger study population and multi-center study are recommended with more homogenous selection of study population. Long term follow up to correlate symptoms with echocardiographic dyssynchrony indices is recommended. Keywords: Coronary Artery Bypass Grafting, Left Ventricular, Mechanical Dyssynchrony, Tissue Doppler imaging