LEFT-VENTRICULAR END-SYSTOLIC VOLUME INDEX IN PATIENTS WITH ISCHEMIC CARDIOMYOPATHY PREDICTS POSTOPERATIVE VENTRICULAR-FUNCTION

Background. We investigated the usefulness of the preoperative left ve ntricular end-systolic volume index (LVESVI) as a predictor of postope rative ventricular function. Methods. We retrospectively reviewed the records of 310 patients who underwent coronary artery bypass grafting and identified 20 patients with ischemic cardiomyopathy with a preoper ative ejection fraction less than 0.30. We determined the preoperative and postoperative ejection fraction, LVESVI, and left ventricular end -diastolic volume index using biplane left cineventriculography. Patie nts were divided into groups depending on whether their preoperative L VESVI was less than 100 mL/m(2) (group A, n = 10) or greater than 100 mL/m(2) (group B, n = 10). Results. The mean ejection fraction increas ed significantly after coronary artery bypass grafting in group A from 0.25 +/- 0.05 to 0.40 +/- 0.09 (p < 0.01), but did not change signifi cantly in group B (0.26 +/- 0.05 versus 0.23 +/- 0.06). The mean LVESV I decreased significantly in group A from 83.2 +/- 13.7 to 61.7 +/- 20 .4 mL/m(2) after operation (p < 0.05), but did not change significantl y in group B (124.7 +/- 21.0 versus 121.5 +/- 37.6 mL/m(2)). In group B, 4 patients had signs of congestive heart failure during the follow- up period and had to be rehospitalized. Conclusions. The mean ejection fraction improved significantly after coronary artery bypass grafting in patients with a preoperative LVESVI less than 100 mL/m(2), despite the presence of a global left ventricular ejection fraction less than 0.30. Our results suggest that the preoperative LVESVI predicts the p ostoperative status and left ventricular function in patients with isc hemic cardiomyopathy.