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PubMed1980

Does cardioplegic arrest compromise long-term left ventricular function?

This study was undertaken to evaluate the chronic, long-term effect of global ischemia produced by cold potassium cardioplegia during cardiopulmonary bypass. Fifteen dogs underwent either control thoracotomy and chronic instrumentation(Group A) or cardiopulmonary bypass and 60 minutes of cold cardioplegic arrest (Group B). With the dogs conscious, hemodynamic variables and left ventricular studies were recorded weekly for 12 weeks postoperatively, both at rest and during volume overload with saline solution. At rest, the heart rate in Group B was 18% higher and stroke volume was 14% lower than Group A. With volume overload, cardiac output and maximum rate of rise of left ventricular pressure in Group B rose only from 3.7 +/- 0.6 to 7.1 +/- 0.8 liters per minute and 2,410 +/- 220 to 2,730 +/- 130 mm Hg per second, respectively, compared with 3.9 +/- 0.6 to 10.4 +/- 0.8 liters per minute and 2,740 +/- 230 to 3,890 +/- 350 mm Hg, respectively, in Group A (p less than 0.01). In Group B, the other variables reached a plateau sooner than in Group A (48 versus 110 seconds). The left ventricular function curve showed a mild decrease in functional capacity and depressed contractility. Therefore, one hour of cardioplegic cardiac arrest caused no depression of function at rest. Mild depression of left ventricular function was demonstrated up to 7 weeks postoperatively during acute volume overload.

Animals↗
PubMed1993

[Beneficial effects of enalapril on the diastolic ventricular function in Chagas myocardiopathy].

PURPOSE: To verify the effect of enalapril on ventricular function and on the incidence of ventricular arrhythmias in patients with Chagas' disease with congestive heart failure. METHODS: We studied 20 patients with Chagas' disease, aged between 24 to 64 (mean 44) years. There were 17 male. All patients have positive serologic blood tests for Chagas' disease (immunofluorescence and Machado-Guerreiro test), left ventricular diastolic diameter superior to 55mm and ejection fraction less than 0.60. The patients were divided aleatory in two groups: control group (CG) with 9 patients receiving conventional treatment (digital and diuretics) and enalapril group (EG), with 11 patients where enalapril was added to conventional treatment. The treatment was maintained during two months and the patients were evaluated at the beginning and at the end, when they were submitted to clinical examination, echo-doppler-cardiogram, stress test and 24h Holter monitoring. At two dimensional echocardiographic study we evaluate left ventricular and left atrial diameters, at doppler study the E/A relations, the systolic volume and cardiac index. At the stress test and Holter monitoring we evaluate the incidence of ventricular arrhythmias. RESULTS: The comparison between initial and final evaluations, showed that there was a significant improvement of diastolic function (p = 0.04) and a trend to improvement of systolic function (great systolic volume and cardiac index) at EG. The incidence of non sustained ventricular tachycardia was the same in the two groups. CONCLUSION: In Chagas' disease enalapril improves significantly diastolic dysfunction in patients with heart failure. After two months of treatment we observed tendency to improvement of systolic dysfunction and the incidence of arrhythmias induced by stress test.

Adult↗
PubMed1975

Myocardial revascularization in patients with poor ventricular function.

Eighty patients with evidence of impaired ventricular function by ventriculography were reviewed. On the basis of the ejection fraction, these patients were divided into three groups. Those with ejection fractions less than 0.2 were considered in very poor condition, those with ejection fractions of 0.2 to 0.4 were considered in poor condition, and those with ejection fractions with between 0.4 and 0.6 were considered fair. Suitability of vessels for bypassing and the presence or absence of collateral cirulation on the cinearteriograms was also noted for possible influence on result. Operative mortality rate in patients having complete repair, defined as bypassing all major vessels with significant obstruction, was 7 per cent. In 26 patients having incomplete repair, the operative mortality was 30 per cent. However, the late mortality rate was not favorably influenced by complete repair, 75 per cent are in improved or good clinical condition, as compared with 65 per cent in the incomplete repair group. As patients with impairment of ventricular contractility are at high risk, it is believed that they should continue to be evaluated on an individual basis for bypass surgery and not categorically denied treatment.

Adult↗
PubMed1990

Differences in the recovery of right and left ventricular function after ischaemic arrest and cardioplegia.

Differential susceptibility of right (RV) and left (LV) ventricles to plain ischaemia and the contribution of cardioplegia in reducing the ischaemic damage was evaluated in a sheep model of cardiopulmonary bypass. Sheep (n = 16) were equally divided for the two protocols of the study. Each sheep served as its own control. RV and LV functions were studied and compared by plotting ventricular function curves (Starling and Sarnoff). The mathematical centre of mass (COM) for each curve was computed by a polynomial regression program. The COM values of the contractility indices [stroke volume (SV), stroke work (SW)] represented ventricular heterometric reserve. RV and LV heterometric reserve was significantly (P less than 0.01) reduced after 1 h plain ischaemia, and quantitatively this change was more for RV than for LV (P less than 0.05). As compared to LV, a significantly greater reduction in RVSW was brought about by a significantly (P less than 0.01) greater reduction in RVSV, because there were no significant differences between the post-ischaemic recovery in the RV and LV afterloads. Cardioplegic protection nearly normalized filling pressure and contractility (SV, SW) of both ventricles, but major differences were observed in the recovery of compliance. Recovery in the RV compliance exceeded the control values, and quantitatively the recovery in RVSW was slightly more than in LVSW. The results of this study indicate that the RV suffers more damage from plain ischaemic arrest and hence benefits more from the cardioplegic protection.

Animals↗
PubMed1976

Ventriculography and coronary arteriography in the acutely III patient. Complications, extent of coronary arterial disease, and abnormalities of left ventricular function.

Of 99 patients who underwent "emergency" diagnostic studies, 82 had "unstable angina" (group A), 15 had recent myocardial infarction (group B), and two had intractable congestive heart failure due to acute mitral regurgitation (group C). Two cardiac and two local complications occurred either during the procedure or during the following 48 hours. There were no deaths or myocardial infarctions. Ten (12 percent) patients of group A had "normal" coronary arteries and normal left ventricular function; 13, 26 and 33 patients had one, two, and three coronary arteries involved, respectively. Those with three-vessel disease had a significantly higher left ventricular end-diastolic pressure (LVEDP) and lower ejection fraction (EF) than those with one- and two-vessel disease. Those with previous myocardial infarction had a significantly higher incidence of reduced EF and of wall motion abnormalities than those without a previous myocardial infarction. All patients in group B had significant coronary arterial disease, and 80 percent (12) had abnormal left ventricular function. Their mean LVEDP and EF were significantly higher and lower, respectively, than those found in group A. In conclusion, acutely ill patients were studied with low risk. Most patients had three- or two-vessel disease. Abnormal left ventricular function was related to three-vessel disease and to recent and old myocardial infarction.

Acute Disease↗
PubMed1996

Effects of intracoronary carbon dioxide on left ventricular function in swine.

BACKGROUND AND HYPOTHESIS: Carbon dioxide is currently used as an arterial and venous contrast agent; however, little is known of its effects on left ventricular function. This study was undertaken to investigate those effects. METHODS: Ascending doses of 5, 10, and 20 ml of carbon dioxide were administered into the left main coronary artery of domestic swine with and without a continuous infusion of intravenous nitroglycerin (50 micrograms/min). RESULTS: Carbon dioxide had an immediate and profound depressant effect on both systolic and diastolic left ventricular function associated with ischemic electrocardiographic changes. Compared with controls (% change), ascending doses of carbon dioxide decreased systolic pressure by -35 +/- 7, -48 +/- 8, and -53 +/- 4 in the absence of nitroglycerin, and by -32 +/- 9, -50 +/- 9, and -60 +/- 9 in the presence of nitroglycerin. Peak+dP/dt decreased by -54 +/- 7, -61 +/- 11, and -64 +/- 3 in the absence of nitroglycerin, and by -36 +/- 13, -55 +/- 11, and -65 +/- 11 in the presence of nitroglycerin. Minimum -dP/dt increased by 65 +/- 8,71 +/- 8, and 77 +/- 3 in the absence of nitroglycerin, and by 63 +/- 7,71 +/- 8, and 78 +/- 7 in the presence of nitroglycerin. No significant changes in heart rate were observed; however, widespread ST-segment elevation was observed in all animals. Coronary angiography following carbon dioxide injection revealed a marked decrease in coronary flow velocity until the gas was cleared from the microcirculation. This was also documented by direct measurement of flow velocity using a Doppler catheter in an additional animal. Left ventriculography demonstrated immediate global dilation and depression of systolic function. CONCLUSIONS: In the swine model, relatively small doses of intracoronary carbon dioxide cause profound yet reversible global left ventricular dysfunction which appears to be ischemic in origin.

Animals↗
PubMed2006

Impact of bronchiectasis on right and left ventricular functions.

Diffuse systemic-pulmonary anastomoses and chronic hypoxemia may result in increase in ventricular work in bronchiectasis. We aimed to assess right ventricular (RV) and left ventricular (LV) functions in patients with bronchiectasis by using tissue Doppler-derived myocardial performance index (MPI), which is a novel and more sensitive parameter than conventional ventricular function parameters. To assess the possibility of RV and LV dysfunctions occurring in bronchiectasis, we studied 25 patients with bronchiectasis, and compared them with 22 age- and gender-matched control subjects. MPI, which is a combined index of both systolic and diastolic ventricular function, was calculated for both ventricles. RV and LV MPIs were also significantly different in patients and the controls. RV MPI was associated with the number of involved lobe, arterial blood oxygen pressure, and acceleration time/ejection time of pulmonary flow. LV MPI was not related to any clinical parameter, but it was correlated only with RV MPI. Ventricular functions are impaired in bronchiectasis. The impairment of RV function is related to involved lung lobe number, arterial oxygen pressure, and acceleration time/ejection time of pulmonary flow. LV dysfunction was correlated only with RV function.

Adult↗
PubMed2004

[Reproducibility of measurements of left ventricular function with gated myocardial perfusion SPECT and comparison with blood pool radionuclide ventriculography].

INTRODUCTION AND OBJECTIVE: This study was designed to evaluate the reproducibility of ejection fraction (EF) and ventricular volume measurements obtained with single photon emission computed tomography (gated-SPECT), and to assess the correlation between EF values obtained with this method and blood pool planar radionuclide ventriculography. PATIENTS AND METHOD: A total of 55 patients were included (37 men, mean age 61.3 years) upon referral to two nuclear cardiology units for diagnosis (50%) or follow-up of known coronary artery disease. In a standard 2-day protocol, patients received a dose of [99mTc]tetrofosmin (800 MBq) at stress and at rest. Two resting gated-SPECT studies were performed. QGS software was used to obtain left ventricular EF, end-diastolic volume (EDV) and end-systolic volume (ESV). Forty-nine patients agreed to undergo blood pool ventriculography on the third day. RESULTS: Interobserver variability was 0.5 (2.6)% (r=0.99) for EF, 1.9 (10.7) mL for EDV (r=0.98) and 0.5 (5.4) mL for ESV (r=0.99). Interassay variability was 2 (5.1)% (r=0.94) for EF, 4.5 (8.6) mL for EDV (r=0.99) and 3.4 (6.6) mL for ESV (r=0.99). The correlation between gated-SPECT EF and blood pool EF was suboptimal (r=0.75, 95%CI, 0.59-0.85). CONCLUSIONS: There was excellent interobserver and interassay reproducibility for left ventricular functional parameters measured with gated-SPECT and QGS software, and this method can be used for serial evaluations of ventricular function. Although the correlation between values obtained with gated-SPECT and blood pool ventriculography was acceptable, the differences show that the two techniques cannot be considered equivalent.

Coronary Disease↗
PubMed2000

Correlation of predischarge electrocardiographic patterns with left ventricular function in patients with anterior wall myocardial infarction.

The aim of this prospective study was to assess the correlation between different predischarge electrocardiographic patterns and left ventricular function, evaluated by physical examination and echocardiography, in patients with first Q wave anterior acute myocardial infarction. A positive correlation was found between the electrocardiographic pattern and wall motion score assessed by echocardiography, reflecting a gradual worsening in left ventricular function among the different patterns. Patients with an isoelectric ST segment and negative T waves had a 73% decrease in the risk of clinical heart failure compared to those who continued to have ST elevation. Thus, a predischarge electrocardiogram can be used as a simple, noninvasive method for the risk stratification of patients with acute myocardial infarction.

Adult↗
PubMed1988

The effects of a critical stenosis on myocardial blood flow, ventricular function, and infarct size after coronary reperfusion.

Immediate percutaneous transluminal coronary angioplasty has been advocated for patients with a residual stenosis after coronary thrombolysis because of the possibility that the residual stenosis may restrict reflow and thereby increase infarct size. Because there are few experimental data bearing on this issue, we measured left ventricular function, myocardial blood flow, and infarct size in 20 anesthetized open-chest dogs during 2 hr of left circumflex occlusion and 4 hr of reperfusion. Ten animals were reperfused through a critical stenosis of the left circumflex artery (critical stenosis group) and the remaining 10 animals underwent full reperfusion without stenosis (control group). In both groups, a comparable degree of echocardiographic systolic wall thinning was present during occlusion and partial recovery of global and regional left ventricular function in the two groups. Subendocardial blood flow was decreased in the critical stenosis group relative to the control group at 5 min after reperfusion (0.52 +/- 0.16 ml/min/g in the critical stenosis group vs 1.55 +/- 0.32 ml/min/g in the control group, p less than .05) but not at 4 hr after reperfusion, when a reduced reflow response was seen in both groups. No differences in subepicardial blood flow were seen in the two groups of animals. Infarct size was slightly greater in the critical stenosis group than the control group, but this difference was not statistically significant (infarct/risk area ratio: 55.5 +/- 7.8% in the critical stenosis group vs 39.4 +/- 9.7% in the control group, p = .21). A close inverse exponential relationship was seen between infarct size/risk area ratio and subendocardial blood flow during occlusion (r = .89, p = .001). Two control animals had high levels of subendocardial collateral flow (greater than 0.2 ml/min/g); when these animals were excluded from analysis, differences in the infarct size/risk area ratio in the control and critical stenosis groups were less striking: (55.5 +/- 7.8% in the critical stenosis group vs 48.4 +/- 9.6% in the control group). Thus, the presence of a critical stenosis results in restriction of hyperemic blood flow to the subendocardium after reperfusion but does not influence infarct size or early left ventricular functional recovery.

Animals↗
PubMed1993

Systolic left ventricular function after reperfusion therapy for acute myocardial infarction. Analysis of determinants of improvement. The TAMI Study Group.

BACKGROUND: Contrast ventriculograms of 542 patients treated with intravenous thrombolytic agents for acute myocardial infarction were examined to define changes in left ventricular ejection fraction and regional wall motion that occur during the first week after reperfusion therapy for acute myocardial infarction and define clinical, acute angiographic and treatment variables related to improvement in global and regional left ventricular function. METHODS AND RESULTS: Intravenous tissue-type plasminogen activator and/or urokinase was administered to 805 patients during acute myocardial infarction. Mean time from symptom onset to thrombolytic therapy was 3 hours (22 patients received therapy within the first hour). Acute and 7-day catheterization were performed. Paired left ventricular ejection fraction and centerline regional wall motion were available in 542 patients (67%). Stepwise, multivariable analysis of clinical, acute angiographic and treatment variables was used to develop two models: One related to improvement in left ventricular ejection fraction, and the second related to improvement in infarct zone regional function. Left ventricular ejection fraction did not change (51.2 +/- 11.1% for acute versus 51.9 +/- 11.0% for 1 week, p = 0.19). Improvement in infarct zone regional function was modest (14%) at 1 week (-2.54 +/- 1.07 standard deviation per chord for acute versus -2.17 +/- 1.24 at 1 week, p < 0.001). Subgroup analysis demonstrated modest improvement in ejection fraction (1.4 +/- 9.5%) and greater improvement in infarct zone function (19%) in patients with successful sustained reperfusion at 1 week. Depressed left ventricular ejection fraction and infarct zone regional wall motion at the acute study were strongly associated with improvement of these parameters at 1 week. Resolution of chest pain before acute catheterization, infarct-related artery flow at acute catheterization, and depressed regional wall motion in the noninfarct zone were associated with improvement in both ejection fraction and regional infarct zone function at 1 week. Notably, the time from the onset of symptoms to initiation of thrombolytic treatment was not related to subsequent improvement in ventricular function. CONCLUSIONS: Dramatic improvement in left ventricular systolic function is not common after thrombolytic therapy for acute myocardial infarction. Improvement in global and regional systolic function is most closely related to acutely depressed ventricular function and successful acute coronary recanalization. Thus, patients with the most myocardium in jeopardy and successful coronary reperfusion demonstrate the greatest improvement in global and infarct zone ventricular function. Overall, the magnitude of this improvement is modest, suggesting that the benefits of coronary reperfusion are not solely related to improvement in systolic left ventricular function.

Aged↗
PubMed1989

[The effect of a combination of ridazolol and molsidomine on hemodynamics and left ventricular function in dilated cardiomyopathy].

Haemodynamics and Left Ventricular Function in Patients with Dilated Cardiomyopathy after a Combination of Ridazolol and Molsidomine. To evaluate the haemodynamic properties of the new beta-blocker ridazolol alone and in combination with the vasodilator molsidomine a randomized study was carried out in 12 patients with dilated cardiomyopathy (NYHA II/III). beta-Blockade leads to a decreasing tendency in blood pressure and heart rate. Pulmonary capillary wedge pressure (PC) was not significantly altered and ejection fraction remained unchanged. Molsidomine showed a decrease of PC. The combination of both drugs revealed both the positive haemodynamic effects of molsidomine and the reduced heart rate of beta-blockade. Negative side effects could not be observed.

Adrenergic beta-Antagonists↗
PubMed1986

Early improvement of left ventricular function during caloric restriction in obesity.

Left ventricular function (LVF) was studied in 25 obese patients (four males and 21 females) by serial poligraphic measurements, namely systolic time intervals (STI), during a short period of dieting (2721 kJ/day (650 kcal/day) as single daily meal regimen). In the same period, all the patients underwent also three standardized exercise tests at the cycloergometer. At the end of the study (20th day), statistically significant differences were obtained in weight loss (P less than 0.001); two main parameters of STI, namely pre-ejection period index (PEPI) and PEP/LVET ratio were lowered (P less than 0.001): furthermore, peak and recovery systolic blood pressure (SBP) and heart rate (HR) during exercising, were also significantly reduced. These data suggest that an improvement of LVF and cardiac performance are present since the early phases of caloric restriction in obesity.

Adolescent↗
PubMed1976

Diabetes mellitus and left ventricular function.

Chronic diabetes mellitus can alter left ventricular function independent of vascular effects. On the basis of available morphologic data in human and canine diabetics, alterations of myocardial interstitium may be the basis for this preclinical abnormality. The abnormal function is independent of apparent duration and treatment by diet, insulin, or hypoglycemic agents. It occurs in both sexes and is independent of age. Whether the observed functional abnormality progresses to clinical heart failure may depend on intensification of the underlying pathophysiology of the myocardium or superimposition of complications such as hypertension, obesity, and obstructive disease of the coronary vessels.

Animals↗
PubMed1994

Lymphocyte beta-adrenergic receptors in young subjects with peripheral or central obesity: relationship with central haemodynamics and left ventricular function.

This study was designed to evaluate total (t) and surface (s) beta-adrenergic receptor (BAR) density and their relationship with central haemodynamics and left ventricular function in young subjects with central or peripheral obesity. A total of 31 obese subjects (BMI > or = 30.5 kg.m-2 for males and > or = 27.3 kg.m-2 for females) aged less than 40 years and without other risk factors for cardiovascular diseases (smoking, hypertension, diabetes and lipid abnormalities) were studied. Nine had peripheral obesity and 22 central obesity according to WHR values; there were 20 lean controls (BMI < 25 kg.m-2 for males and < 24.7 kg.m-2 for females). Casual (c) and 24 h ambulatory mean blood pressures (MBP-24 h) were determined. BAR density was evaluated according to Böyum and De Blasi methods. Plasma catecholamines by high perfusion liquid chromatography and fasting immunoreactive plasma insulin (IRI) were also measured by RIA. Radionuclide angiocardiography was used to determine central haemodynamics and both systolic and diastolic left ventricular function. Total peripheral resistances (TPR) and intravascular volumes were also determined. Echocardiographic study was used to measure LVM, LVM.h-1, LVDD and IVS. Left ventricular ejection fraction (LVEF), peak filling rate (PFR), BARt and BARs were significantly lower (P < 0.05) and cardiac output, cardiac volumes, LVM, LVM. h-1 and time to PFR significantly higher (P < 0.05) in both obese groups than in lean controls. Plasma IRI was significantly (P < 0.05) higher in both obese groups whereas plasma norepinephrine was higher only in central obese.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1982

[Noninvasive evaluation of cardiac involvements and left ventricular function in schoolchildren with the history of mucocutaneous lymph node syndrome].

Mucocutaneous lymph node syndrome (MCLS) in the young has been known to have coronary aneurysms, and then it has been recently suspected as a cause of premature atherosclerosis and cardiomyopathy. Thirty-three schoolchildren who suffered from MCLS were studied to evaluate cardiac involvements and left ventricular function using two-dimensional (2-D) echocardiograms and submaximal stress test. Fifteen normal schoolchildren were studied as normal control. All these MCLS children were asymptomatic and had no significant findings in routine chest X-ray and electrocardiographic examinations. According to submaximal stress test, 8 cases showed a J type ST depression of only 0.5--1.0 mm, and there were no positive cases. Using 2-D echocardiograms, the left coronary artery was detected in 85% and the right coronary in 27%. One case showed an aneurysm of the left coronary artery. However, none of them showed abnormal left ventricular wall motion or the wall motion abnormality compatible with cardiomyopathy. There were no significant differences between MCLS and normal control in ejection fraction, mean VCF, diastolic descent rate of the anterior mitral valve, D/S ratio of the left ventricular wall, and Weissler's index (PEP/ET). These findings suggested that 1) most of MCLS schoolchildren do not have obvious cardiac involvement and their left ventricular function is within normal limits, 2) because of its low sensitivity, submaximal stress test is not so useful in screening coronary lesions, and 3) the 2-D echocardiogram works not only in detecting coronary aneurysms but also in evaluating left ventricular function.

Adolescent↗
PubMed1984

Scintigraphic determination of ventricular function and coronary perfusion in long-distance runners.

Left ventricular function and coronary perfusion were evaluated with rest-exercise gated blood pool and stress-redistribution thallium scans in a group of long-distance runners and compared to a group of catheterization-proved normal subjects. Exercise duration, work load, and oxygen consumption were significantly greater for long-distance runners. Rest end-diastolic volume (EDV), end-systolic volume (ESV), and stroke volumes (SV) were significantly larger in long-distance runners than in control subjects, while ejection fraction (EF), cardiac index (CI), and ejection rate were similar in both groups. Exercise EDV increased and ESV decreased, producing an increase in SV and EF in long-distance runners. Exercise EDV did not change and ESV decreased less, producing lesser increase in SV and EF in the control group. Qualitative evaluation of thallium scans showed apparent perfusion defects with normal redistribution in six myocardial segments in five long-distance runners. Quantitative evaluation demonstrated initial defects, which persisted on delay scans, but were associated with normal relative redistribution in three ventricular walls in three long-distance runners. In conclusion, left ventricular reserve function was greater in long-distance runners than in control subjects. Endurance exercise can be associated with apparent myocardial perfusion defects, which may be due to uneven ventricular hypertrophy resulting from the pressure and volume loads imposed by exercise.

Adult↗
PubMed1990

[Evaluation of the effects of coronary artery bypass grafting on left ventricular function in patients with previous myocardial infarction].

The present study was designed to assess a left ventricular function following coronary artery bypass grafting (CABG) in patients with previous myocardial infarction (MI). The subject was consisted of 10 patients with MI (MI(+) group) and 6 without it (MI(-) group). Both groups underwent complete revascularization. Stroke index (SI), ejection fraction (EF), systolic pressure/end-systolic volume index (SP/ESVI) and end-diastolic volume index (EDVI) were evaluated utilizing radionuclide angiography at rest and during exercise (Ex) before and after CABG. The influence of size of myocardial infarction on left ventricular function were also analyzed. Preoperatively during Ex, EF showed decrease, SP/ESVI no change and EDVI increase in both MI(+) and MI(-) group compared with those at rest. Postoperatively during Ex, SI, EF and EDVI showed no change and SP/ESVI increase in both MI(+) and MI(-) group compared with those at rest. Ejection fraction and SP/ESVI during Ex in MI(+) group had significant differences compared with those in both MI(-) group and control group. Ejection fraction and SP/ESVI during Ex in MI(-) showed no difference compared with those in control group. The size of MI suggested by ECG scoring system (proposed by Wagner GS et al, Circulation '82) had negative correlations with both Ex-induced increment of postoperative EF and Ex-induced increase ratio of postoperative SP/ESVI. These data indicated that complete revascularization improved EF and SP/ESVI in patients with MI, and moreover normalized those in patients without MI. But in the case of extensive MI, even complete revascularization might not recover poor functional reserve during Ex.

Adult↗