PMID- 36524083
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221222
IS  - 2072-1439 (Print)
IS  - 2077-6624 (Electronic)
IS  - 2072-1439 (Linking)
VI  - 14
IP  - 11
DP  - 2022 Nov
TI  - Retrospective, observational analysis of cardiac function associated with global 
      preoperative myocardial scar in patients with ischemic cardiomyopathy after 
      coronary artery bypass grafting.
PG  - 4319-4328
LID - 10.21037/jtd-22-846 [doi]
AB  - BACKGROUND: Drawing on accumulated patient data from a hospital database, the 
      goal of this retrospective study was to analyze cardiac function associated with 
      global preoperative myocardial scarring assessed by cardiac magnetic resonance 
      with late gadolinium enhancement (CMR-LGE) in patients with ischemic 
      cardiomyopathy (ICM) after coronary artery bypass grafting (CABG). METHODS: A 
      total of 57 patients diagnosed with ICM who underwent isolated CABG at Beijing 
      Anzhen Hospital between September 2017 and September 2019 were enrolled in this 
      retrospective study. All these patients underwent a preoperative CMR-LGE 
      examination. Based on postoperative echocardiography results at 6 months, cases 
      were divided into the following 2 groups: improved cardiac function [a difference 
      of left ventricular ejection fraction (LVEF) greater than or equal to 5%] and 
      unimproved cardiac function. The factors contributing to these patients' 
      unimproved cardiac function were investigated. RESULTS: At 6 months after 
      surgery, 64.9% (37/57) of cases had improved cardiac function, and 35.1% (20/57) 
      had no improvement. There was no statistical difference between the 2 groups in 
      the Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac 
      Surgery (SYNTAX) score (41.7+/-7.6 vs. 42.8+/-8.3; P=0.603), but compared to the 
      improved group, preoperative myocardial scarring was significantly enlarged in 
      the unimproved group (41.9%+/-6.4% vs. 27.8%+/-8.5%; P<0.001). In regression 
      analysis, only preoperative myocardial scarring [odds ratio (OR) =1.44; 95% 
      confidence interval (CI): 1.13-1.83; P=0.003] was associated with no change in 
      cardiac function evaluated by echocardiography after CABG. The median follow-up 
      of 1.6 years (range, 0.6-4.1 years) found that the unimproved group had a higher 
      incidence of major adverse cardiovascular and cerebrovascular events (MACCEs) 
      (8.1% vs. 25.0%; P=0.044), and that the New York Heart Association (NYHA) 
      classification of the unimproved group was higher than that of the improved group 
      (P=0.018). CONCLUSIONS: In ICM patients, a greater amount of preoperative 
      myocardial scarring is associated with unimproved cardiac function after CABG. 
      The measurement of preoperative myocardial scarring may aid clinicians in 
      identifying patients who would benefit from CABG.
CI  - 2022 Journal of Thoracic Disease. All rights reserved.
FAU - Fu, Wei
AU  - Fu W
AD  - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical 
      University, Beijing, China.
FAU - Zhao, Yang
AU  - Zhao Y
AD  - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical 
      University, Beijing, China.
FAU - Zhang, Kui
AU  - Zhang K
AD  - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical 
      University, Beijing, China.
FAU - Dai, Qinyi
AU  - Dai Q
AD  - Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 
      Beijing, China.
FAU - Biekan, Jumatay
AU  - Biekan J
AD  - Circle Cardiovascular Imaging, Calgary, AB, Canada.
FAU - Zheng, Jubing
AU  - Zheng J
AD  - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical 
      University, Beijing, China.
FAU - Dong, Ran
AU  - Dong R
AD  - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical 
      University, Beijing, China.
FAU - Mu, Junsheng
AU  - Mu J
AD  - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical 
      University, Beijing, China.
LA  - eng
PT  - Journal Article
PL  - China
TA  - J Thorac Dis
JT  - Journal of thoracic disease
JID - 101533916
PMC - PMC9745517
OTO - NOTNLM
OT  - Ischemic cardiomyopathy (ICM)
OT  - cardiac magnetic resonance-late gadolinium enhancement
OT  - coronary artery bypass grafting (CABG)
OT  - unimproved cardiac function
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at 
      https://jtd.amegroups.com/article/view/10.21037/jtd-22-846/coif). The authors 
      have no conflicts of interest to declare.
EDAT- 2022/12/17 06:00
MHDA- 2022/12/17 06:01
PMCR- 2022/11/01
CRDT- 2022/12/16 02:33
PHST- 2022/06/17 00:00 [received]
PHST- 2022/09/23 00:00 [accepted]
PHST- 2022/12/16 02:33 [entrez]
PHST- 2022/12/17 06:00 [pubmed]
PHST- 2022/12/17 06:01 [medline]
PHST- 2022/11/01 00:00 [pmc-release]
AID - jtd-14-11-4319 [pii]
AID - 10.21037/jtd-22-846 [doi]
PST - ppublish
SO  - J Thorac Dis. 2022 Nov;14(11):4319-4328. doi: 10.21037/jtd-22-846.