Faculty of Medicine

Permanent URI for this communityhttps://repository.ukim.mk/handle/20.500.12188/14

Browse

Settings

Author: search.filters.author.Grazhdani S

Search Results

Now showing 1 - 2 of 2
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    CORONARY ARTERY BYPASS GRAFTING PORTENDS DECREASED RIGHT VENTRICULAR FUNCTION
    (Macedonian Association od Anatomists, 2020-07-03)
    ;
    ;
    Sokarovski, M
    ;
    ;
    Lazovski, N
    Decreased right ventricular (RV) function is a frequently observed phenomenon after coronary artery bypass grafting (CABG) that often implicated poor long term prognosis. The aim of this study was to assess the existence of RV dysfunction 4 to 6 months after CABG using echocardiographic Assessment of tricuspid annular plane systolic motion (TAPSE) and RV free wall longitudinal strain (RVFWS) using speckle tracking. During the period from October 2017 to October 2018, forty-seven consecutive patients undergoing CABG were enrolled in this prospective study. 2D transthoracic echocardiography was performed within one week before CABG as well as 4 to 6 months after surgery. All measurements were made by a single experienced investigator.4-6 months after CABG right atrial (RA)and RV dimensions were significantly increased although the mean value stayed in reference margins. TAPSE was significantly reduced (p=0.0001) as well as RVFWS (p=0.015) which showed fewer negative results implicating decrement in RV function after surgery. Patients with abnormal postoperative RVFWS had insignificantly larger preoperative end-diastolic and end-systolic volume index as well as worse left ventricular (LV)function manifested with lower LV ejection fraction (LVEF), lower systolic volume index (SVI) and more positive LV global longitudinal strain.We could not find any significant difference among preoperative values of RA and RV dimension as well as TAPSE and PAPs between patients with normal vs. abnormal postoperative RVFWS. Our study showed depressed RV function 4-6 months after CABG. We suggest that RV free wall strain could be obtained and should be applied along with other conventional markers in the assessment of RV function after CABG.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    Changes of left ventricular systolic function in patients undergoing coronary artery bypass grafting
    (Scientific Foundation SPIROSKI, 2019)
    ;
    ;
    Sokarovski M
    ;
    Ristevski P
    ;
    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.