초록접수 현황
| 16F-160 | 구연 발표 |
Factors Associated with Improvement of Left Ventricular Ejection Fraction after Off-Pump Coronary Artery Bypass Grafting in Patients with Low Ejection Fraction
Jung-Hwan Kim, Seung Hyun Lee, Hyun-Chel Joo, Kyung-Jong Yoo, Young-Nam Youn
Department of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
Background : To identify the factors associated with improvement of left ventricular ejection fraction (LVEF) after off-pump coronary artery bypass grafting (OPCAB) in patients with low LVEF.
Methods : From January 2001 to December 2014, total 2778 patients underwent isolated OPCAB. Among them, 1101 patients had the available pre-operative and post-operative echocardiographic data over 6-month from the surgery. In these patients, 351 patients had the LVEF less than 50% and divided into two groups. Improvement group was defined as improvement of LVEF 10% or more (n=126) on follow-up echocardiography and Non-Improvement group was less than 10% (n=225). Pre-operative and post-operative echocardiographic data were collected including regional wall motion abnormality (RWMA) index and presence of thinning. Mean follow-up duration was 6.78±3.71 years (Range, 0.51-15.55 years).
Results : The patients’ mean age was 63.9±9.1 years and mean pre-operative LVEF was 38.25±8.15%. The mean distal anastomosis was 3.21±0.76 and the mean difference of LVEF compared with pre-operation was 6.92±10.20% (Range, -28%~+39%). Improvement of LVEF showed long-term survival benefit on multivariate analysis (HR:0.470, 95% CI:0.263-0.840, p=0.011). Predictors for improvement of LVEF 10% or more were recent myocardial infarction (HR:1.882, 95% CI:1.005-3.525, p=0.048), grafting to total obstructive lesion (HR:1.943, 95% CI:1.033-3.655, p=0.039), high RWMA index (HR:2.370, 95% CI:1.406-3.994, p=0.001), and absence of left ventricular wall thinning (HR:1.866, 95% CI:1.075-3.239, p=0.027).
Conclusion : Improvement of LVEF after OPCAB in patients with low LVEF was associated with increased long-term survival. And left ventricular function can be improved by surgical revascularization in patients with high RWMA index without wall thinning, early revascularization to total obstructive lesion.
Methods : From January 2001 to December 2014, total 2778 patients underwent isolated OPCAB. Among them, 1101 patients had the available pre-operative and post-operative echocardiographic data over 6-month from the surgery. In these patients, 351 patients had the LVEF less than 50% and divided into two groups. Improvement group was defined as improvement of LVEF 10% or more (n=126) on follow-up echocardiography and Non-Improvement group was less than 10% (n=225). Pre-operative and post-operative echocardiographic data were collected including regional wall motion abnormality (RWMA) index and presence of thinning. Mean follow-up duration was 6.78±3.71 years (Range, 0.51-15.55 years).
Results : The patients’ mean age was 63.9±9.1 years and mean pre-operative LVEF was 38.25±8.15%. The mean distal anastomosis was 3.21±0.76 and the mean difference of LVEF compared with pre-operation was 6.92±10.20% (Range, -28%~+39%). Improvement of LVEF showed long-term survival benefit on multivariate analysis (HR:0.470, 95% CI:0.263-0.840, p=0.011). Predictors for improvement of LVEF 10% or more were recent myocardial infarction (HR:1.882, 95% CI:1.005-3.525, p=0.048), grafting to total obstructive lesion (HR:1.943, 95% CI:1.033-3.655, p=0.039), high RWMA index (HR:2.370, 95% CI:1.406-3.994, p=0.001), and absence of left ventricular wall thinning (HR:1.866, 95% CI:1.075-3.239, p=0.027).
Conclusion : Improvement of LVEF after OPCAB in patients with low LVEF was associated with increased long-term survival. And left ventricular function can be improved by surgical revascularization in patients with high RWMA index without wall thinning, early revascularization to total obstructive lesion.
책임저자: Young-Nam Youn
Department of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
발표자: Jung-Hwan Kim, E-mail : jhkim0907@yuhs.ac