ctives : Studies on the effect of Coronary Artery bypass Graft Surgery (CABG) on segmental left ventricular wall motion have yield conflicting results. So we assessed changes of segmenal left ventricular wall motion in patients with coronary
artery
disease after CABG and advantage of 2-dimensional echocardiography on evaluating its effectiveness.
Methods : 20 patients with coronary artery disease (12 unstable angina pectoris, 8 acute
myocardial infarction) were studied with 2-dimensional echocardiography before and early 8.3
±3.3 (mean±SD) and late 204.5±105.9 days after CABG. The changes in segmental wall
motion were assessed quantitatively by assigning a segmental wall motion score
recommended by ASE(1: normal, 2: hypokinesia 3:akinesia, 4: dyskinseia, 5: aneurysm) to each
of 16 echocardiographically defined segments by 45-degree rotating apical 4-plane views (8 in
basal, 8 in apical).
Results :
1) The mean left ventrivular segmental wall motion score sis not change significantly (1.10
±0.37, 1.25±0.47, 1.12±0.40;befror, early and late after CABG respectively).
2) there was a significant change in septal wall motion at early postoperative study
[37(46%) of the 80 septal segments; 1.14±0.41, 1.59±0.59(p<0.001): before and early after
CABG respectively], and the worsening segments were nearly normalized at late postoperative
study [24(92%) of 26 segments].
3) The segments with normal motion preoperatively remained normal late postoperatively
[169(99%) of 171 normal segment preoperatively].
4) Most of the preoperative abnormal segments [23(96%) of 24 segments] were in patients
with acute MI and a half of them (11 segments) were normalized at late postoperative study.
5) While the anterior or anteroseptal preoperative abnormal segments were usually
improved postoperatively, the posterior or inferior abnormal segments were not changed
significantly.
Conclusion : A part of the abnormal segmental left ventricular wall motion in coronary
artery disease can be improved after CABG and 2-dimensional echocardiography may be
beneficial to assessing not only the changes of segmental left ventricular wall motion motion
quantitatively but also the effectiveness of CABG
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