Skip to main content
NCBI home page
The Journal of Clinical Investigation logoLink to The Journal of Clinical Investigation
. 1976 Dec;58(6):1339–1347. doi: 10.1172/JCI108589

Videometric analysis of regional left ventricular function before and after aortocoronary artery bypass surgery: correlation of peak rate of myocardial wall thickening with late postoperative graft flows.

J H Chesebro, E L Ritman, R L Frye, H C Smith, D C Connolly, B D Rutherford, G D Davis, G K Danielson, J R Pluth, D A Barnhorst, R B Wallace
PMCID: PMC333305  PMID: 1086858

Abstract

The peak rate of systolic wall thickening (pdTw/dt) in regions of the left ventricle was determined by biplane roentgen videometry in 60 patients before and a median of 14 mo after aorto-coronary bypass graft surgery. The left ventricular ejection fraction, stroke volume, and end-diastolic volume and pressure did not change significantly after surgery in the presence of patent or occluded grafts (P greater than 0.05). Statistically significant increases occurred in the peak rate of systolic wall thickening regions supplied by patent bypass grafts, and significant decreases occurred in regions with occluded grafts (P less than 0.01). Of 42 preoperatively hypokinetic regions (pdTw/dt greater than 0 less than 5.0 cm/s) supplied by a patent graft, 30 improved by an average of 2.6 cm/s after operation; 18 returned to normal. Failure of 24 hypokinetic regions to improve to normal was associated with myocardial infarction in 11 or with late postoperative graft blood flows of less than 60 ml/min measured by videodensitometry, in 10. All seven preoperatively akinetic (pdTw/dt=0) or dyskinetic (pdTw/dt less than 0) regions did not improve after the operation despite the fact that, in five of the seven, coronary bypass flows were over 60 ml/min. All eight preoperatively hypokinetic regions supplied by coronary artery graft flows of less than or equal 40 ml/min failed to improve to normal after operation. All nine preoperatively hypokinetic regions supplied by coronary artery graft flows of over 60 ml/min improved to normal after surgery. Late postoperative coronary artery bypass graft flows, the functional status of the myocardium, the status and distribution of the native coronary circulation, and decreased regional function elsewhere in the ventricle must all be considered when regional left ventricular function is interpreted.

Full text

PDF
1339

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arbogast R., Solignac A., Bourassa M. G. Influence of aortocoronary saphenous vein bypass surgery on left ventricular volumes and ejection fraction. Comparison before and one year after surgery in 51 patients. Am J Med. 1973 Mar;54(3):290–296. doi: 10.1016/0002-9343(73)90023-5. [DOI] [PubMed] [Google Scholar]
  2. Assad-Morell J. L., Frye R. L., CONNOLLY D. C., Gau G. T., Pluth J. R., Barnhorst D. A., WALLACE R. B., Davis G. D., Elveback L. R., Danielson G. K. Relation of intraoperative or early postoperative transmural myocardial infarction to patency of aortocoronary bypass grafts and to diseased ungrafted coronary arteries. Am J Cardiol. 1975 Jun;35(6):767–773. doi: 10.1016/0002-9149(75)90110-1. [DOI] [PubMed] [Google Scholar]
  3. Bartel A. G., Behar V. S., Peter R. H., Orgain E. S., Kong Y. Exercise stress testing in evaluation of aortocoronary bypass surgery. Report of 123 patients. Circulation. 1973 Jul;48(1):141–148. doi: 10.1161/01.cir.48.1.141. [DOI] [PubMed] [Google Scholar]
  4. Bassan M., Ganz W., Marcus H. S., Swan H. J. The effect of intracoronary injection of contrast medium upon coronary blood flow. Circulation. 1975 Mar;51(3):442–445. doi: 10.1161/01.cir.51.3.442. [DOI] [PubMed] [Google Scholar]
  5. Bourassa M. G. Editorial: Left ventricular performance following direct myocardial revascularization. Circulation. 1973 Nov;48(5):915–916. doi: 10.1161/01.cir.48.5.915. [DOI] [PubMed] [Google Scholar]
  6. Bourassa M. G., Lésperance J., Campeau L., Saltiel J. Fate of left ventricular contraction following aortocoronary venous grafts. Early and late postoperative modifications. Circulation. 1972 Oct;46(4):724–730. doi: 10.1161/01.cir.46.4.724. [DOI] [PubMed] [Google Scholar]
  7. CHAPMAN C. B., BAKER O., REYNOLDS J., BONTE F. J. Use of biplane cinefluorography for measurement of ventricular volume. Circulation. 1958 Dec;18(6):1105–1117. doi: 10.1161/01.cir.18.6.1105. [DOI] [PubMed] [Google Scholar]
  8. Chaitman B. R., Bristow J. D., Rahimtoola S. H. Left ventricular wall motion assessed by using fixed external reference systems. Circulation. 1973 Nov;48(5):1043–1054. doi: 10.1161/01.cir.48.5.1043. [DOI] [PubMed] [Google Scholar]
  9. Chatterjee K., Swan H. J., Parmley W. W., Sustaita H., Marcus H. S., Matloff J. Influence of direct myocardial revascularization on left ventricular asynergy and function in patients with coronary heart disease. With and without previous myocardial infarction. Circulation. 1973 Feb;47(2):276–286. doi: 10.1161/01.cir.47.2.276. [DOI] [PubMed] [Google Scholar]
  10. Corday E. Myocardial revascularization. Need for hard facts. JAMA. 1972 Jan 24;219(4):507–508. doi: 10.1001/jama.1972.03190300043014. [DOI] [PubMed] [Google Scholar]
  11. Danielson G. K., Gau G. T., Davis G. D. Early results of vein bypass grafts for coronary artery disease. Mayo Clin Proc. 1973 Jul;48(7):487–491. [PubMed] [Google Scholar]
  12. Deal P., Elliott L. P., Bartley T. D., Wheat M. W., Jr, Ramsey H. W. Quantitative left ventriculography in the immediate postoperative period after aorto-coronary bypass. J Thorac Cardiovasc Surg. 1973 Jul;66(1):1–11. [PubMed] [Google Scholar]
  13. Dumesnil J. G., Ritman E. L., Frye R. L., Gau G. T., Rutherford B. D., Davis G. D. Quantitative determination of regional left ventricular wall dynamics by roentgen videometry. Circulation. 1974 Oct;50(4):700–708. doi: 10.1161/01.cir.50.4.700. [DOI] [PubMed] [Google Scholar]
  14. Gould K. L., Lipscomb K., Hamilton G. W. Physiologic basis for assessing critical coronary stenosis. Instantaneous flow response and regional distribution during coronary hyperemia as measures of coronary flow reserve. Am J Cardiol. 1974 Jan;33(1):87–94. doi: 10.1016/0002-9149(74)90743-7. [DOI] [PubMed] [Google Scholar]
  15. Griffith L. S., Achuff S. C., Conti C. R., Humphries J. O., Brawley R. K., Gott V. L., Ross R. S. Changes in intrinsic coronary circulation and segmental ventricular motion after saphenous-vein coronary bypass graft surgery. N Engl J Med. 1973 Mar 22;288(12):589–595. doi: 10.1056/NEJM197303222881201. [DOI] [PubMed] [Google Scholar]
  16. Hammermeister K. E., Kennedy J. W., Hamilton G. W., Stewart D. K., Gould K. L., Lipscomb K., Murray J. A. Aortocoronary saphenous-vein bypass. Failure of successful grafting to improve resting left ventricular function in chronic angina. N Engl J Med. 1974 Jan 24;290(4):186–192. doi: 10.1056/NEJM197401242900403. [DOI] [PubMed] [Google Scholar]
  17. Jacob K., Chabot M., Saltiel J., Campeau L. Improvement of left ventricular asynergy following aortocoronary bypass surgery related to preoperative electrocardiogram and vectorcardiogram. Am Heart J. 1973 Oct;86(4):438–443. doi: 10.1016/0002-8703(73)90133-6. [DOI] [PubMed] [Google Scholar]
  18. Lapin E. S., Murray J. A., Bruce R. A., Winterscheid L. Changes in maximal exercise performance in the evaluation of saphenous vein bypass surgery. Circulation. 1973 Jun;47(6):1164–1173. doi: 10.1161/01.cir.47.6.1164. [DOI] [PubMed] [Google Scholar]
  19. McConahay D. R., McCallister B. D., Hallermann F. J., Smith R. E. Comparative quantitative analysis of the electrocardiogram and the vectorcardiogram. Correlations with the coronary arteriogram. Circulation. 1970 Aug;42(2):245–259. doi: 10.1161/01.cir.42.2.245. [DOI] [PubMed] [Google Scholar]
  20. Moran S. V., Tarazi R. C., Urzua J. U., Favaloro R. G., Effler D. B. Effects of aorto-coronary bypass on myocardial contractility. J Thorac Cardiovasc Surg. 1973 Mar;65(3):335–342. [PubMed] [Google Scholar]
  21. Rees G., Bristow J. D., Kremkau E. L., Green G. S., Herr R. H., Griswold H. E., Starr A. Influence of aortocoronary bypass surgery on left ventricular performance. N Engl J Med. 1971 May 20;284(20):1116–1120. doi: 10.1056/NEJM197105202842002. [DOI] [PubMed] [Google Scholar]
  22. Ritman E. L., Sturm R. E., Wood E. H. Biplane roentgen videometric system for dynamic (60-sec) studies of the shape and size of circulatory structures, particularly the left ventricle. Am J Cardiol. 1973 Aug;32(2):180–187. doi: 10.1016/s0002-9149(73)80118-3. [DOI] [PubMed] [Google Scholar]
  23. Rutherford B. D., Gau G. T., Danielson G. K., Pluth J. R., Davis G. D., Wallace R. B., Frye R. L. Left ventricular haemodynamics before and soon after saphenous vein bypass graft operation for angina pectoris. Br Heart J. 1972 Nov;34(11):1156–1162. doi: 10.1136/hrt.34.11.1156. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Shepherd R. L., Itscoitz S. B., Glancy D. L., Stinson E. B., Reis R. L., Olinger G. N., Clark C. E., Epstein S. E. Deterioration of myocardial function following aorto-coronary bypass operation. Circulation. 1974 Mar;49(3):467–475. doi: 10.1161/01.cir.49.3.467. [DOI] [PubMed] [Google Scholar]
  25. Smith H. C., Frye R. L., Donald D. E., Davis G. D., Pluth J. R., Sturm R. E., Wood E. H. Roentgen videodensitometric measure of coronary blood flow. Determination from simultaneous indicator-dilution curves at selected sites in the coronary circulation and in coronary artery-saphenous vein grafts. Mayo Clin Proc. 1971 Dec;46(12):800–806. [PubMed] [Google Scholar]
  26. Smith H. C., Sturm R. E., Wood E. H. Videodensitometric system for measurement of vessel blood flow, particularly in the coronary arteries, in man. Am J Cardiol. 1973 Aug;32(2):144–150. doi: 10.1016/s0002-9149(73)80112-2. [DOI] [PubMed] [Google Scholar]
  27. Spencer F. C., Green G. E., Tice D. A., Glassman E. Bypass grafting for occlusive disease of the coronary arteries: a report of experience with 195 patients. Ann Surg. 1971 Jun;173(6):1029–1044. doi: 10.1097/00000658-197106010-00022. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Wood E. H. Cardiovascular and pulmonary dynamics by quantitative imaging. Circ Res. 1976 Mar;38(3):131–139. doi: 10.1161/01.res.38.3.131. [DOI] [PubMed] [Google Scholar]
  29. de Jong J. W., Goldstein S. Changes in coronary venous inosine concentration and myocardial wall thickening during regional ischemia in the pig. Circ Res. 1974 Jul;35(1):111–116. doi: 10.1161/01.res.35.1.111. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Investigation are provided here courtesy of American Society for Clinical Investigation

RESOURCES