Radionuclide angiographic assessment of global and segmental left ventricular function at rest and during exercise after coronary artery bypass graft surgery

Journal Article · Mon Nov 01 04:00:00 EST 1982 · Circulation; (United States)

DOI:https://doi.org/10.1161/01.CIR.66.5.972· OSTI ID:6766309

Lim, Y L; Kalff, V; Kelly, M J; Mason, P J; Currie, P J; Harper, R W; Anderson, S T; Federman, J; Stirling, G R; Pitt, A

Left ventricular ejection fraction (LVEF) was measured by radionuclide angiography at rest and during supine bicycle exercise before and 3 months after coronary artery bypass graft surgery (CABG) in 20 patients with chronic stable angina. The right anterior oblique gated first-pass technique was used to assess LVEF response to maximal exercise (Wmax), while the left anterior oblique equilibrium-gated technique was used to assess LVEF and relative LV volume changes during graded submaximal exercise. Mean LVEF was unchanged at rest after CABG by both the first-pass (60 +/- 12% vs 60 +/- 12%) and equilibrium-gated (61 +/- 13% vs 62 +/- 13%) measurements. At Wmax, mean first-pass LVEF was significantly higher postoperatively than preoperatively (63 +/- 17% vs 53 +/- 17%; p less than 0.01) with a higher Wmax (750 +/- 182 vs 590 +/- 202 kpm/min; p less than 0.001) and higher rate-pressure product (302 +/- 59 vs 222 +/- 57 units; p less than 0.001). Similarly, equilibrium-gated LVEF levels during graded exercise, using stepwise regression analysis, were significantly higher postoperatively than preoperatively (p less than 0.001); at the highest graded work load, they averaged 63 +/- 19% postoperatively and 53 +/- 17% preoperatively, with higher work loads (500 +/- 190 vs 417 +/- 155; p less than 0.05) and higher rate-pressure products (271 +/- 55 vs 207 +/- 53; p less than 0.001). The increase in exercise LVEF after surgery was due to a marked decrease in the ratio, relative to resting values, of counts-based end-systolic volumes during submaximal exercise (preoperatively 1.91 +/- 1.04; postoperatively 1.14 +/- 0.46; p less than 0.01). The five subjects in whom LVEF decreased significantly during exercise postoperatively all had one or more blocked or stenosed grafts. This study documents, by two independent radionuclide techniques, an improved LVEF during exercise at an increased maximal work capacity and rate-pressure product 3 months after successful CABG.

• Research Organization: Cardiology Service, Alfred Hospital, Melbourne, Victoria, Australia
• OSTI ID: 6766309
• Journal Information: Circulation; (United States), Journal Name: Circulation; (United States) Vol. 66:5; ISSN CIRCA
• Country of Publication: United States
• Language: English

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59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
ARTERIES
BLOOD CIRCULATION
BLOOD VESSELS
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
CORONARIES
COUNTING TECHNIQUES
DIAGNOSTIC TECHNIQUES
DIAGNOSTIC USES
DISEASES
DRUGS
EVALUATION
EXERCISE
GRAFTS
HEART
LABELLED COMPOUNDS
ORGANS
PATHOLOGY
PATIENTS
RADIOISOTOPE SCANNING
RADIOPHARMACEUTICALS
SCINTISCANNING
TRANSPLANTS
USES