Abstract
BACKGROUND: For patients with advanced, diffuse Coronary artery disease (CAD), surgical myocardial revascularization via coronary artery bypass grafting (CABG) continues to represent the gold standard therapeutic approach. Given the paucity of studies demonstrating CABG benefits in patients with significant left intraventricular dyssynchrony (LVD), we conducted this study to evaluate how viable myocardial tissue volume, quantified by dobutamine stress echocardiography (DSE), predicts postoperative LVD improvement. METHODS: This investigation employed a cross-sectional analytical design to assess 30 CABG candidates with moderate-severe ischemic cardiomyopathy. Myocardial viability evaluation utilized dobutamine stress echocardiography, complemented by tissue Doppler Imaging for synchronized assessment of regional LV contractility. RESULTS: Demographic analysis revealed a study population aged 61.5±7.9 years (range: 47 to 85 years), comprising 73.3% males. Left ventricular ejection fraction (LVEF) measurements improved from 32.2±4.6% at baseline to 39.6±5.2 % following surgical revascularization (p<0.001). Postoperative resolution of left ventricular dyssynchrony occurred in 9 patients (30.0 %), whereas 19 patients (63.3 %) showed no improvement (p<0.001). Two patients (6.6 %) died due to progressive heart failure and inadequate revascularization. CONCLUSION: Our current study demonstrates significant postoperative improvements in LVEF, LVEDD, and left ventricular dyssynchrony. However, given that approximately two-thirds of cases showed only minimal improvement in dyssynchrony, it would be reasonable to consider cardiac resynchronization therapy (CRT) for these patients.