Ventricular function after coronary artery bypass grafting: Evaluation by magnetic resonance imaging and myocardial strain analysis Hersh S. Maniar,

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Presentation transcript:

Ventricular function after coronary artery bypass grafting: Evaluation by magnetic resonance imaging and myocardial strain analysis Hersh S. Maniar, MD, Brian P. Cupps, PhD, D.Dean Potter, MD, Pavlos Moustakidis, MD, Cindy J. Camillo, ANP, Celeste M. Chu, BS, Michael K. Pasque, MD, Thoralf M. Sundt, MD The Journal of Thoracic and Cardiovascular Surgery Volume 128, Issue 1, Pages 76-82 (July 2004) DOI: 10.1016/j.jtcvs.2003.10.028

Figure 1 Representation of short-axis MRI of LV at end-diastole (A) and end-systole (B). B-splines are overlaid on tissue tags created in myocardial surface. C, Displacements of points within myocardium are calculated through systole and represented by vectors. The Journal of Thoracic and Cardiovascular Surgery 2004 128, 76-82DOI: (10.1016/j.jtcvs.2003.10.028)

Figure 2 Regional circumferential strain from control subjects. Asterisks indicate regional circumferential strain significantly greater for lateral walls (anterolateral, posterolateral) than for anterior (ANT) and posterior (POST) walls (P < .001). Double asterisks indicate circumferential strain for either septal wall (anteroseptal, posteroseptal) significantly less (P < .001) than for any other wall (anterior, posterior, anterolateral, posterolateral). There was minimal variability within any given region (SD 0.04-0.05). AS, Anteroseptal; AL, anterolateral; PL, posterolateral; PS, posteroseptal. The Journal of Thoracic and Cardiovascular Surgery 2004 128, 76-82DOI: (10.1016/j.jtcvs.2003.10.028)

Figure 3 Regional circumferential strain among ischemic patients before CABG. Circumferential strain is represented along x-axis, beginning with severely abnormal to normal. Each data point represents preoperative region among ischemic patients. Depressed circumferential strain accounted for 64% of ventricular regions (23/36). Three segments failed to produce any circumferential shortening (arrows) and had circumferential strain of 0 or less. PS, Posteroseptal; POST, posterior; PL, posterolateral; AL, anterolateral; ANT, anterior; AS, anteroseptal. The Journal of Thoracic and Cardiovascular Surgery 2004 128, 76-82DOI: (10.1016/j.jtcvs.2003.10.028)

Figure 4 Correlation of ejection fraction and global circumferential strain. Preoperative ejection fraction, as determined by ventriculography in right anterior oblique projection, demonstrated linear relationship with global circumferential strain obtained from tissue-tagged MRI (r = 0.84, P < .01). The Journal of Thoracic and Cardiovascular Surgery 2004 128, 76-82DOI: (10.1016/j.jtcvs.2003.10.028)

Figure 5 Regional circumferential strain among ischemic patients after CABG. Circumferential strain is represented along x-axis beginning with severely abnormal (abnl) to normal. After CABG, number of regions with depressed circumferential strain decreased to 36% (13/36). Number of severely abnormal segments decreased from 13 to 5. Arrows represent same 3 preoperative segments that had circumferential strain of 0 or less. PS, Posteroseptal; POST, posterior; PL, posterolateral; AL, anterolateral; ANT, anterior; AS, anteroseptal. The Journal of Thoracic and Cardiovascular Surgery 2004 128, 76-82DOI: (10.1016/j.jtcvs.2003.10.028)

Figure 6 Global circumferential strains before (Preop) and after (Postop) CABG. Asterisks indicate postoperative global circumferential strain improved significantly (P < .02). Plus sign indicates postoperative global circumferential strain trended toward significance (P = .09). Postoperative circumferential strain for patients 1, 3, 5, and 6 was consistent with regained normal LV wall motion. The Journal of Thoracic and Cardiovascular Surgery 2004 128, 76-82DOI: (10.1016/j.jtcvs.2003.10.028)