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Eur J Cardiothorac Surg 2002;21:32-35
© 2002 Elsevier Science NL

Myocardial perfusion correlates with improvement of systolic function of the left ventricle after CABG. Dobutamine echocardiography and Tc-99m-MIBI SPECT study

L. Paluszkiewicz^a*, P. Kwinecki^a, M. Jemielity^a, A. Szyszka^b, W. Dyszkiewicz^a, A. Cieliski^b

^a Department of Cardiac Surgery, Institute of Cardiology, 61-848 Pozna ul. Duga 1/2, Poland
^b Department of Cardiology, Institute of Cardiology, 61-848 Pozna ul. Duga 1/2, Poland

Received 10 October 2000; received in revised form 3 October 2001; accepted 5 November 2001.

* Corresponding author. Tel.: +48-61-852-1021; fax: +48-61-826-6338
e-mail: lpalusz{at}poczta.onet.pl

Objective: The aim of the study was to assess the effect of surgical revascularization [coronary artery bypass grafting (CABG)] on systolic function and perfusion of the left ventricle using dobutamine echocardiography (DE) and Tc-99m-MIBI SPECT (SPECT). Methods: There were 32 patients mean age 52.2±7.2 years in whom DE and SPECT were performed before and 3–4 months after CABG using standard protocols. Wall motion score index (WMSI) and perfusion index (PI) were calculated. Results: Significant improvement of WMSI at rest (1.44±0.46 vs 1.33±0.41; P=0.03) as well as after maximal dose of dobutamine (1.49±0.42 vs 1.39±0.44; P=0.02) was observed after CABG as compared to preoperative examination. Similar relation was observed during SPECT study. Perfusion index diminished significantly after revascularization during rest acquisition (2.19±0.71 vs 1.93±0.70; P=0.0008) and after Dipirydamole administration (2.73±0.73 vs 2.20±0.69; P=0.0001) as compared to preoperative examination. We found correlation between PI and WMSI at rest before CABG (R=0.46; P=0.01), PI after Dipirydamole and WMSI after maximal dose of Dobutamine before CABG (R=0.37; P=0.04), PI and WMSI at rest after CABG (R=0.39; P=0.03), PI after Dipirydamole and WMSI after dobutamine after CABG (R=0.38; P=0.03). Conclusions: Surgical revascularization significantly improves both perfusion and contractility. Increased perfusion after CABG correlates with improvement of systolic function of the left ventricle.

Key Words: Dobutamine • Technetium-99m-sestamibi • Echocardiography • Revascularization • Systolic function