Implication of right ventricular dysfunction on long-term outcome in patients with ischemic cardiomyopathy undergoing coronary artery bypass grafting.

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Presentation transcript:

Implication of right ventricular dysfunction on long-term outcome in patients with ischemic cardiomyopathy undergoing coronary artery bypass grafting with or without surgical ventricular reconstruction Tomasz Kukulski, MD, PhD, Lilin She, PhD, Normand Racine, MD, Sinisa Gradinac, MD, Julio A. Panza, MD, Eric J. Velazquez, MD, Kwan Chan, MD, Mark C. Petrie, MD, Kerry L. Lee, PhD, Patricia A. Pellikka, MD, Alexander Romanov, MD, Jolanta Biernat, MD, Jean L. Rouleau, MD, Carmen Batlle, MD, Jan Rogowski, MD, Paolo Ferrazzi, MD, Marian Zembala, MD, Jae K. Oh, MD The Journal of Thoracic and Cardiovascular Surgery Volume 149, Issue 5, Pages 1312-1321 (May 2015) DOI: 10.1016/j.jtcvs.2014.09.117 Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Chart illustrating the design of STICH patient selection for RV function analysis. CABG, Coronary artery bypass grafting; RV, right ventricular; STICH, Surgical Treatment for Ischemic Heart Failure; SVR, surgical ventricular reconstruction. The Journal of Thoracic and Cardiovascular Surgery 2015 149, 1312-1321DOI: (10.1016/j.jtcvs.2014.09.117) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Associations between degree of RV dysfunction. A, LV remodeling expressed by LV EDV, ESV, and EF. B, LV diastolic properties represented by DT, E/A, and E/e′. C, Left atrial remodeling expressed by MR severity, left atrial volume, and pulmonary artery systolic pressure (all differences among RV dysfunction subgroups are significant, nonparametric Kruskal–Wallis test). DT, Deceleration time; EF, ejection fraction; LA, left atrial; LVEDV, left ventricular end-diastolic volume; LVESV, left ventricular end-systolic volume; MR, mitral regurgitation; PASP, pulmonary artery systolic pressure; RV, right ventricular. E/A, early/late velocity ratio; E/e′, early mitral flow/early annular velocity ratio. The Journal of Thoracic and Cardiovascular Surgery 2015 149, 1312-1321DOI: (10.1016/j.jtcvs.2014.09.117) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Impact of the coexisting RV dysfunction on long-term outcome in the analyzed cohort of STICH patients (n = 866). Kaplan–Meier estimates of event rate by RV dysfunction status. CI, Confidence interval; RV, right ventricular; CV, cardiovascular. The Journal of Thoracic and Cardiovascular Surgery 2015 149, 1312-1321DOI: (10.1016/j.jtcvs.2014.09.117) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 A, Interaction of RV dysfunction and treatment allocation. Kaplan–Meier estimates of event rate by treatment group and LV dysfunction groups. B, Interaction of RV dysfunction and treatment allocation. Kaplan–Meier estimates of event rate by treatment group and LV dysfunction groups. CABG, Coronary artery bypass grafting; CI, confidence interval; CV, cardiovascular; RV, right ventricular; SVR, surgical ventricular reconstruction. The Journal of Thoracic and Cardiovascular Surgery 2015 149, 1312-1321DOI: (10.1016/j.jtcvs.2014.09.117) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions