Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Apr;122(4):e20240486.
doi: 10.36660/abc.20240486.

The Effect of Coronary Artery Bypass Graft Surgery on Contractile Function and Symptoms in Patients with Left Ventricular Dysfunction

[Article in Portuguese, English]
Fernando Bassan  1 , Roberto Esporcatte  2 , Marcelo Goulart Correia, Octavio Drummond Guina  1 , Guilherme de Souza Weigert  1 , Gracielle Christine do Nascimento Oliveira  1
Affiliations

The Effect of Coronary Artery Bypass Graft Surgery on Contractile Function and Symptoms in Patients with Left Ventricular Dysfunction

[Article in Portuguese, English]
Fernando Bassan et al. Arq Bras Cardiol. 2025 Apr.

Abstract
in English, Portuguese

Background: The degree of left ventricular (LV) dysfunction is an independent risk factor for poor outcomes in patients with chronic coronary syndrome. Coronary artery bypass graft (CABG) is the standard care for the management of ischemic heart failure to improve symptoms and prognosis. However, the predictors of improvement are still uncertain.

Objective: To assess the effect of myocardial revascularization on LV function and symptoms in patients with CCS and reduced left ventricular ejection fraction (LVEF), as well as to identify the improvement predictors.

Methods: We retrospectively analyzed the data and clinical status of 136 consecutive patients with LVEF<50% that underwent CABG. During clinical follow-up echocardiographic LV function was reassessed at the short-term (3.6 months) and long-term (30.8 months), and compared to baseline.

Results: Mean pre-operative LVEF was 40.9 ± 8.6% and wall motion score index (WMSI) was 1.99 ± 0.36, both improving at long-term to 48.1 ± 15.0% (p<0.001) and 1.75 ± 0.49 (p<0.001), respectively. We observed that 55.7% of the patients presented an improvement of LVEF≥10% and 58.1% in WMSI ≥10%. Univariate logistic regression analysis revealed that cerebrovascular disease was the only variable to be predictor of LVEF improvement. At the end of follow-up, we observed a reduction in the rate of patients in functional class III/IV when compared to baseline (65.4 vs. 10.3% - p<0.001).

Conclusions: Patients with CCS and reduced LVEF undergoing CABG experienced improvement in both LV contractile function and size, with beneficial response in functional class.

Fundamento: O grau de disfunção do ventrículo esquerdo (VE) é um fator de risco independente para piores desfechos em pacientes com síndrome coronariana crônica (SCC). A cirurgia de revascularização miocárdica (CRVM) é a estratégia terapêutica padrão na insuficiência cardíaca isquêmica para melhorar os sintomas e o prognóstico. No entanto, os preditores de melhora ainda são incertos.

Objetivos: Avaliar o efeito da revascularização miocárdica sobre a função do VE e sintomas em pacientes com SCC e fração de ejeção do ventrículo esquerdo (FEVE) reduzida, e identificar os preditores de melhora.

Métodos: Analisamos, retrospectivamente, dados e condição clínica de 136 pacientes consecutivos com FEVE <50%, submetidos à CRVM. Durante o acompanhamento ecocardiográfico, a função do VE foi reavaliada no curto (3,6 meses) e longo prazo (30,8 meses), e comparada com os dados basais.

Resultados: A FEVE média no pré-operatório foi 40,9 ± 8,6% e a média do escore do índice de motilidade (WMSI) foi 1,99 ± 0,36, ambos melhorando no longo prazo para 48,1 ± 15,0% (p<0,001) e 1,75 ± 0,49 (p<0,001), respectivamente. Observamos que 55,7% dos pacientes apresentaram uma melhora na FEVE ≥10% e 58,1% no WMSI ≥10%. A análise de regressão logística revelou que a doença cerebrovascular foi a única variável preditora de melhora na FEVE. No final do acompanhamento, observamos uma redução na taxa de pacientes em classe funcional III/IV em comparação ao basal (65,4 vs. 10,3% - p<0,001).

Conclusões: Pacientes com SCC e FEVE reduzida, submetidos à CRVM apresentaram melhora na função contrátil e no tamanho do VE, com resposta benéfica sobre a classe funcional.

PubMed Disclaimer

Conflict of interest statement

Potencial conflito de interesse: Não há conflito com o presente artigo

Figures

Figura 1
Figura 1. – Diagrama de Sankey apresentando a mudança na fração de ejeção do ventrículo esquerdo (%) do basal ao seguimento de curto prazo e seguimento de longo prazo.
Figura Central
Figura Central. : O Efeito da Cirurgia de Revascularização Miocárdica na Função Contrátil e Sintomas em Pacientes com Disfunção Ventricular Esquerda
Central Illustration
Central Illustration. : The Effect of Coronary Artery Bypass Graft Surgery on Contractile Function and Symptoms in Patients with Left Ventricular Dysfunction
Figure 1
Figure 1. – Sankey diagrams depicting the change in LVEF (%) from baseline to short and long-term follow-up.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Wong M, Staszewsky L, Latini R, Barlera S, Glazer R, Aknay N, et al. Severity of Left Ventricular Remodeling Defines Outcomes and Response to Therapy in Heart Failure: Valsartan Heart Failure Trial (Val-HeFT) Echocardiographic Data. J Am Coll Cardiol. 2004;43(11):2022–2027. doi: 10.1016/j.jacc.2003.12.053. - DOI - PubMed
    1. Topkara VK, Cheema FH, Kesavaramanujam S, Mercando ML, Cheema AF, Namerow PB, et al. Coronary Artery Bypass Grafting in Patients with Low Ejection Fraction. Circulation. 2005;112(9) Suppl:I344–I350. doi: 10.1161/CIRCULATIONAHA.104.526277. - DOI - PubMed
    1. Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM, et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update from the GBD 2019 Study. J Am Coll Cardiol. 2020;76(25):2982–3021. doi: 10.1016/j.jacc.2020.11.010. - DOI - PMC - PubMed
    1. Felker GM, Shaw LK, O'Connor CM. A Standardized Definition of Ischemic Cardiomyopathy for Use in Clinical Research. J Am Coll Cardiol. 2002;39(2):210–218. doi: 10.1016/s0735-1097(01)01738-7. - DOI - PubMed
    1. Breathett K, Allen LA, Udelson J, Davis G, Bristow M. Changes in Left Ventricular Ejection Fraction Predict Survival and Hospitalization in Heart Failure with Reduced Ejection Fraction. Circ Heart Fail. 2016;9(10):e002962. doi: 10.1161/CIRCHEARTFAILURE.115.002962. - DOI - PMC - PubMed