Left ventricular end-systolic volume index in patients with ischemic cardiomyopathy predicts postoperative ventricular function

Background. We investigated the usefulness of the preoperative left ventricular end-systolic volume index (LVESVI) as a predictor of postoperative ventricular function. Methods. We retrospectively reviewed the records of 310 patients who underwent coronary artery bypass grafting and identified 20 patients with ischemic cardiomyopathy with a preoperative ejection fraction less than 0.30. We determined the preoperative and postoperative ejection fraction, LVESVI, and left ventricular end-diastolic volume index using biplane left cineventriculography. Patients were divided into groups depending on whether their preoperative LVESVI was less than 100 mL/m2 (group A, n = 10) or greater than 100 mL/m2 (group B, n = 10). Results. The mean ejection fraction increased significantly after coronary artery bypass grafting in group A from 0.25 ± 0.05 to 0.40 ± 0.09 (p < 0.01), but did not change significantly in group B (0.26 ± 0.05 versus 0.23 ± 0.06). The mean LVESVI decreased significantly in group A from 83.2 ± 13.7 to 61.7 ± 20.4 mL/m2 after operation (p < 0.05), but did not change significantly in group B (124.7 ± 21.0 versus 121.5 ± 37.6 mL/m2). In group B, 4 patients had signs of congestive heart failure during the follow-up period and had to be rehospitalized. Conclusions. The mean ejection fraction improved significantly after coronary artery bypass grafting in patients with a preoperative LVESVI less than 100 mL/m2, despite the presence of a global left ventricular ejection fraction less than 0.30. Our results suggest that the preoperative LVESVI predicts the postoperative status and left ventricular function in patients with ischemic cardiomyopathy.