Predictive value of myocardial perfusion in the prognosis after coronary artery bypass grafting_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WANG Wenjun ¹ , PAN Xiaofang ² , GAO Feng ¹ , ZHANG Bo ² , SUN Feiyi ² , ZHUANG Xijing ¹ ,  HE Xuezhi ¹

1. Department of Cardiovascular Surgery, Dalian Municipal Central Hospital, Dalian, 116033, Liaoning, P.R.China;
2. Department of Cardiovascular Ultrasound Imaging, Dalian Municipal Central Hospital, Dalian, 116033, Liaoning, P.R.China;

Corresponding author：

HE Xuezhi, Email: dlmchcsd@163.com

Keywords：

Myocardial perfusion; coronary artery bypass grafting; major adverse cardiovascular events; prognosis

DOI：

10.7507/1007-4848.202002064

Video：

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Objective To evaluate the value of myocardial perfusion change before and after coronary artery bypass grafting (CABG) in predicting postoperative major adverse cardiovascular events (MACE).Methods A total of 70 CABG patients who received CABG completed by the same operator from January to November 2017 were selected, including 45 males and 25 females with an average age of 64.83±9.09 years. The patients were divided into two groups according to whether the patients had MACE after 1 year of the surgery, including a non-MACE group (group A, n=60) and a MACE group (group B, n=10). The clinical data of patients were compared.Results There were statistical difference in the myocardial contrast echocardiography (MCE) score in the group A before and after surgery (P<0.05), and there were statistically significant differences in the left ventricular size and left ventricular ejection fraction (LVEF) value before and 1 year after surgery (P<0.001), but no statistically significant difference in the size of left atrium (P=0.075). There was no significant difference in the preoperative and postoperative MCE score, and preoperative and postoperative 1-year cardiac ultrasound score in the group B (P>0.05).Conclusion The change of myocardial perfusion after CABG surgery is associated with postoperative MACE. The evaluation of myocardial perfusion before and after CABG surgery is of great significance for the prognosis evaluation of patients.

Citation： WANG Wenjun, PAN Xiaofang, GAO Feng, ZHANG Bo, SUN Feiyi, ZHUANG Xijing, HE Xuezhi. Predictive value of myocardial perfusion in the prognosis after coronary artery bypass grafting. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(12): 1423-1428. doi: 10.7507/1007-4848.202002064 Copy

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2.	Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS guideline on myocardial revascularization. Eur Heart J, 2019, 40(2): 87-165.
3.	Yang N, Su YF, Li WW, et al. Microcirculation function assessed by adenosine triphosphate stress myocardial contrast echocardiography and prognosis in patients with nonobstructive coronary artery disease. Medicine (Baltimore), 2019, 98(27): e15990.
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6.	Hicks KA, Tcheng JE, Bozkurt B, et al. 2014 ACC/AHA key data elements and definitions for cardiovascular endpoint events in clinical trials: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Cardiovascular Endpoints Data Standards). J Am Coll Cardiol, 2015, 66(4): 403-469.
7.	Porter TR, Mulvagh SL, Abdelmoneim SS, et al. Clinical applications of ultrasonic enhancing agents in echocardiography: 2018 American Society of Echocardiography guidelines update. J Am Soc Echocardiogr, 2018, 31(3): 241-274.
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9.	Jiang L, Yao H, Liang ZG. Postoperative assessment of myocardial function and microcirculation in patients with acute coronary syndrome by myocardial contrast echocardiography. Med Sci Monit, 2017, 23: 2324-2332.
10.	Aggeli C, Polytarchou K, Felekos I, et al. Effect of gender on the prognostic value of dobutamine stress myocardial contrast echocardiography. Hellenic J Cardiol, 2017, 58(6): 419-424.
11.	曾嘉慧, 李薇, 廖志红, 等. 平板运动负荷超声心动图结合心肌声学造影对运动中高血压反应患者心肌微循环的评估. 中国医学影像技术, 2019, 16(10): 735-741.
12.	吴志霞, 李春梅, 苏叶. 心肌声学造影与心肌造影负荷超声心动图在冠心病中的临床应用进展. 心血管病学进展, 2019, 40(2): 252-256.
13.	郭景, 邓又斌, 刘娅妮, 等. 心肌超声造影评估心梗患者心肌微循环损伤程度. 放射学实践, 2018, 33(10): 1093-1096.
14.	Kaul S. Assessment of myocardial collateral blood flow with contrast echocardiography. Korean Circ J, 2015, 45(5): 351-356.
15.	Pathan F, Marwick TH. Myocardial perfusion imaging using contrast echocardiography. Prog Cardiovasc Dis, 2015, 57: 632-643.
16.	Zheng XZ, Shi YY, Chen KQ, et al. Evaluation of regional myocardial perfusion in methamphetamine abusers using real-time myocardial contrast echocardiography. Med Ultrason, 2019, 21(1): 56-61.
17.	Orde S, Slama M, Pathan F, et al. Feasibility of myocardial perfusion assessment with contrast echocardiography: can it improve recognition of significant coronary artery disease in the ICU? Critical Care, 2019, 23(1): 257.
18.	Sun L, Wang Z, Xu T, et al. The value of real-time myocardial contrast echocardiography for detecting coronary microcirculation function in coronary artery disease patients. Anatol J Cardiol, 2018, 19(1): 27-33.
19.	Liu C, Xiu C, Xiao X, et al. Microvascular damage after coronary artery bypass surgery: assessment using dobutamine stress myocardial contrast echocardiography. Am J Med Sci, 2014, 347(5): 387-392.
20.	Marc MC, Iancu AC, Ober CD, et al. Pre-revascularization coronary wedge pressure as marker of adverse long-term left ventricular remodeling in patients with acute ST-segment elevation myocardial infarction. Sci Rep, 2018, 8(1): 1897.
21.	Ferreira JP, Rossello X, Pitt B, et al. Eplerenone in patients with myocardial infarction and "mid-range" ejection fraction: An analysis from the EPHESUS trial. Clin Cardiol, 2019, 42(11): 1106-1112.

1. Kulik A, Ruel M, Jneid H, et al. Secondary prevention after coronary artery bypass graft surgery: A scientific statement from the American Heart Association. Circulation, 2015, 131(10): 927-964.
2. Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS guideline on myocardial revascularization. Eur Heart J, 2019, 40(2): 87-165.
3. Yang N, Su YF, Li WW, et al. Microcirculation function assessed by adenosine triphosphate stress myocardial contrast echocardiography and prognosis in patients with nonobstructive coronary artery disease. Medicine (Baltimore), 2019, 98(27): e15990.
4. 刘畅, 修春红, 肖喜刚, 等. 负荷心肌造影对冠状动脉旁路移植术后心肌微循环的评价. 中华胸心血管外科杂志, 2016, 32(3): 155-158.
5. Taqui S, Ferencik M, Davidson BP, et al. Coronary microvascular dysfunction by myocardial contrast echocardiography in nonelderly patients referred for computed tomographic coronary angiography. J Am Soc Echocardiogr, 2019, 32(7): 817-825.
6. Hicks KA, Tcheng JE, Bozkurt B, et al. 2014 ACC/AHA key data elements and definitions for cardiovascular endpoint events in clinical trials: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Cardiovascular Endpoints Data Standards). J Am Coll Cardiol, 2015, 66(4): 403-469.
7. Porter TR, Mulvagh SL, Abdelmoneim SS, et al. Clinical applications of ultrasonic enhancing agents in echocardiography: 2018 American Society of Echocardiography guidelines update. J Am Soc Echocardiogr, 2018, 31(3): 241-274.
8. Roberto ML, Luigi PB, Victor MA, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging, 2016, 17(4): 412.
9. Jiang L, Yao H, Liang ZG. Postoperative assessment of myocardial function and microcirculation in patients with acute coronary syndrome by myocardial contrast echocardiography. Med Sci Monit, 2017, 23: 2324-2332.
10. Aggeli C, Polytarchou K, Felekos I, et al. Effect of gender on the prognostic value of dobutamine stress myocardial contrast echocardiography. Hellenic J Cardiol, 2017, 58(6): 419-424.
11. 曾嘉慧, 李薇, 廖志红, 等. 平板运动负荷超声心动图结合心肌声学造影对运动中高血压反应患者心肌微循环的评估. 中国医学影像技术, 2019, 16(10): 735-741.
12. 吴志霞, 李春梅, 苏叶. 心肌声学造影与心肌造影负荷超声心动图在冠心病中的临床应用进展. 心血管病学进展, 2019, 40(2): 252-256.
13. 郭景, 邓又斌, 刘娅妮, 等. 心肌超声造影评估心梗患者心肌微循环损伤程度. 放射学实践, 2018, 33(10): 1093-1096.
14. Kaul S. Assessment of myocardial collateral blood flow with contrast echocardiography. Korean Circ J, 2015, 45(5): 351-356.
15. Pathan F, Marwick TH. Myocardial perfusion imaging using contrast echocardiography. Prog Cardiovasc Dis, 2015, 57: 632-643.
16. Zheng XZ, Shi YY, Chen KQ, et al. Evaluation of regional myocardial perfusion in methamphetamine abusers using real-time myocardial contrast echocardiography. Med Ultrason, 2019, 21(1): 56-61.
17. Orde S, Slama M, Pathan F, et al. Feasibility of myocardial perfusion assessment with contrast echocardiography: can it improve recognition of significant coronary artery disease in the ICU? Critical Care, 2019, 23(1): 257.
18. Sun L, Wang Z, Xu T, et al. The value of real-time myocardial contrast echocardiography for detecting coronary microcirculation function in coronary artery disease patients. Anatol J Cardiol, 2018, 19(1): 27-33.
19. Liu C, Xiu C, Xiao X, et al. Microvascular damage after coronary artery bypass surgery: assessment using dobutamine stress myocardial contrast echocardiography. Am J Med Sci, 2014, 347(5): 387-392.
20. Marc MC, Iancu AC, Ober CD, et al. Pre-revascularization coronary wedge pressure as marker of adverse long-term left ventricular remodeling in patients with acute ST-segment elevation myocardial infarction. Sci Rep, 2018, 8(1): 1897.
21. Ferreira JP, Rossello X, Pitt B, et al. Eplerenone in patients with myocardial infarction and "mid-range" ejection fraction: An analysis from the EPHESUS trial. Clin Cardiol, 2019, 42(11): 1106-1112.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Predictive value of myocardial perfusion in the prognosis after coronary artery bypass grafting

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