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ORIGINAL ARTICLE
Year : 2017  |  Volume : 5  |  Issue : 1  |  Page : 6-10

Prognostic value of dobutamine stress echocardiography in patients with myocardial dysfunction undergoing coronary artery bypass grafting


1 Department of Cardiac Surgery, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Cardiology, Najafabad Branch, Islamic Azad University, Najafabad, Isfahan, Iran

Correspondence Address:
Dr. Ahmad Mirdamadi
Department of Cardiology, Najafabad Branch, Islamic Azad University, Najafabad, Isfahan
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ACVI.ACVI_3_18

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Background: Given the high capability of dobutamine stress echocardiography (DSE) in the actual estimation of the ventricular function and the prediction of the intraoperative or postoperative outcomes of revascularization, especially following coronary artery bypass grafting (CABG), we aimed to assess the relationship between DSE findings and CABG outcomes. Methods: This retrospective case–control study was conducted on forty patients with left ventricular (LV) systolic dysfunction who underwent CABG during an 8-year period. All the patients were assessed with DSE to determine their ventricular functional status. Checklists containing DSE findings based on the latest guideline, demographics, and the outcomes of revascularization were filled out for the participants. Telephone follow-up was done for all the participants after 6 months. The data were analyzed using SPSS, version 16. Results: Resting LV ejection fraction (LVEF) ≤25%, peak DSE LVEF ≤35%, absolute increase in the LVEF (LVEF change) <8%, a minimum resting wall motion score index (WMSI) of 2, a post-DSE WMSI >2.25, a minimum pulmonary artery pressure (PAP) of 30 mmHg, and nonviable myocardium had positive correlations with the short- and long-term complications of CABG. These correlations were statistically significant between a maximum pre-DSE LVEF of 25% and an LVEF change of < 8% and the operating room complications (P < 0.001) and between nonviable myocardium and the complications in the intensive care unit (ICU; P < 0.001). However, our results did not show that the peak DSE LVEF, WMSI, PAP, and nonviable myocardium were the significant predictors of death due to CABG. It appears that only a pre-LVEF of <25% is a significant predictor of death after CABG (P < 0.001). Conclusions: DSE findings were able to predict complications in the operating room and in the ICU, especially in the participants with low LVEFs.


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