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Access type: UnknownSubject: search.filters.subject.left ventricular function

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    Left ventricular function assessed by gated SPECT after vasodilatator stress in correlation with myocardial perfusion
    (2019-10)
    Mileva, M
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    Stoilovska, B
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    Zdravkovska,M
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    Objective.To evaluate the relationship between the presence of myocardial perfusion abnormality during an adenosine or dipyridamole stress test and the changes in left ventricular (LV) function obtained at rest and after stress with gated SPECT. Material and Methods.Retrospective observational study,with the study population of 92 patients,equally divided in adenosine and dipyridamole vasodilatator stress.The gated SPECT cquisition was performed both at rest and after vasodilator stress, by utilizing rest-stres Tc 99m sestamibi ECG gated SPECT. Global left ventricular ejection fraction (LVEF), end diastolic, end-systolic and stroke volumes (EDV, ESV, SV ),cardiac output and cardiac index at rest and after stress were analyzed,as a function of presence and type of perfusion defect.Result.In our study population, 44 (47,8%) patients had abnormal myocardial perfusion,38(41,3%)having ischaemia (extent 12,6+7,4%), 2(2,5%)scar(extent 10,3+4,5%),and 4(4,3%) having fixed defect (extent 10,7 +6,7%) consistent with LBBB. Patients with perfusion defect had statistically significantly higher end-diastolic,end-systolic and stroke volumes,both in rest and after stress, however significantly lower ejection fraction was observed as compared to normal.They also had OR 2.5 for RV enlargement (CI 0,9-6,4),p=0.048.However,they had preserved even significantly higher cardiac outpu and cardiac index as compared with patients without perfusion defect.The post-stress LVEF and ESV were significantly different from dose measured at rest. ROC curves demonstrated excellent performance of classification of LV functional parameters during rest and over stress conditions, except for LVEF after stress.Conclusion Presence and extent of myocardial perfusion abnormality is reflecting in left ventricular functional parameters, except for the post –stress LVEF, that may not reflect true resting measurements.
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    Changes of left ventricular systolic function in patients undergoing coronary artery bypass grafting
    (Scientific Foundation SPIROSKI, 2019)
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    Sokarovski M
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    Ristevski P
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    AIM: This prospective study was designed to evaluate the changes in left ventricular (LV) systolic function after coronary artery bypass grafting (CABG) in patients with both normal and abnormal pre-operative systolic function. METHODS: During the period from October 2017 to October 2018, forty-seven consecutive patients undergoing CABG were enrolled in this prospective study. Transthoracic echocardiography was performed within 1 week before CABG as well as 4 to 6 months after surgery. All measurements were made by a single experienced investigator. RESULTS: While the mean LV ejection fraction (LVEF) showed neither improvement nor significant reduction in the whole group of patients following CABG (from 54.21 􏰪 15.36 to 53.66 􏰪 11.56%, p = 0.677), significant improvement in LVEF was detected in the subgroup of patients with pre-operative LV dysfunction (from 40.05 􏰪 8.65 to 45.85 􏰪 9.04%, p = 0.008). On the other hand, there was a significant decline in LEFT in the subgroup of patients with normal pre-operative LEFT (from 64.70 􏰪 9.72 to 59.44 􏰪 9.75%, p = 0.008). As for the other parameters of systolic function, significant decrease in LV end-diastolic volume index (LVEDVI) (p = 0.001), LV end-systolic volume index (LVESVI) (p = 0.0001), wall motion score index (WMSI) (p = 0.013) and LVmass index in male patients (p = 0.011) was shown only in patients with decreased LVEF after CABG. Patients with improved postoperative LVEF (53.2% of all patients) had significantly lower baseline LVEF (p = 0.0001), higher LVESVI (0.009) and higher WMSI (p = 0.006) vs patients with worsened postoperative LVEF (38.3% of all patients). Postoperative improvement of LVEF was correlated with stabile angina, lack of preoperative myocardial infarction and smoking, higher baseline WMSI, higher LV internal diameters and indexed volumes in diastole and systole and lower baseline LVEF. In stepwise linear regression analysis the value of baseline LVEF appeared as independent predictor of improved LVEF after CABG (B = 0,836%; 95% CI 0.655-1.017; p = 0.0001). CONCLUSION: Our study showed that LVEF, internal baseline diameters and indexed volumes of LV in diastole and systole are important determinants of postoperative change in LVEF. In patients with preoperative depressed myocardial function, there is an improvement in systolic function, whereas in patients with preserved preoperative myocardial function, the decline in postoperative LVEF was detected.
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    Predictive value of left ventricular function on prognosis in patients undergoing coronary artery bypass surgery
    (Macedonian Academy of Sciences and Arts, 2005-08)
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    Borozanov, V
    In order to assess the predictive value of left ventricular (LV) function on prognosis during 16 years of follow-up we retrospectively/prospectively evaluated 320 patients (mean age 55.9 +/- 9.2 years; 44 women, 276 men) undergoing coronary artery bypass surgery. Patients were divided according to the assessed echocardiographically pre- and postoperative LV ejection fraction (LVEF) into two groups: patients with LV dysfunction (EF < 55%) and patients with preserved LV function (EF >or= 55%). In order to assess the prognostic variables, patients were further subdivided into a group with severely depressed LV function (EF <or= 35%). Operative mortality was 2.0% in patients with LVEF < 55% and 4.5% in patients with LVEF <or= 35%, not showing a statistically significant increase of mortality regarding the reduction of preoperative assessed EF. In contrast to the preoperative assessed EF, which could not be found to be a predictive factor of long-term prognosis, in patients with LV dysfunction registered by postoperative assessed EF increased frequency of coronary events as well as a shorter time of its occurrence with acceptable long-term survival was documented. In patients undergoing surgical myocardial revascularization, symptoms of LV failure and postoperative assessed EF were found as independent predictors of prognosis. We can conclude that surgical myocardial revascularization in patients with coronary artery disease and LV failure can be performed safely, providing a relatively long-term period of time without coronary events including cardiac death. Postoperative assessed LV systolic function appeared as a significant predictor of the clinical outcome.