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The Journal of Thoracic and Cardiovascular Surgery, Vol 103, 849-854, Copyright © 1992 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Exercise response assessed by continuous monitoring of ventricular function in patients with coronary bypass operations

M Kawasuji, H Takemura, T Tedoriya, S Sawa, J Taki and T Iwa
Department of Surgery (I), Kanazawa University School of Medicine, Japan.

The response of left ventricular function during exercise and recovery after exercise was assessed in 35 patients with coronary artery bypass grafting before and after the operation by means of a continuous ventricular function monitor, which records serial beat-to-beat radionuclide data and calculates left ventricular ejection fractions every 20 seconds. The mean ejection fraction decreased with graded bicycle exercise from 48% +/- 9% to 41% +/- 11% (p less than 0.001) before operation but increased with exercise from 50% +/- 9% to 55% +/- 11% (p less than 0.001) after operation. Cardiac response was divided into four types with respect to the profiles of the ejection fractions during exercise. Type A continued to increase; type B initially increased but then decreased in late exercise stages; type C did not change significantly; type D continued to decrease. Most patients had type C or D responses before operation but type A after operation. Seven patients with occluded grafts or ungrafted coronary arteries had type B or D responses. Three patients with complete revascularization, including an internal thoracic artery and saphenous vein grafts, had type B responses. Three patients with extensive infarction and poor left ventricular function showed type C. In the early recovery period after exercise, most patients had an "overshoot" elevation of ejection fraction. The mean value increased from 59% +/- 10% before operation to 64% +/- 11% after operation (p less than 0.01). The recovery time after exercise was reduced from 2.8 minutes before operation to 1.8 minutes after operation (p less than 0.001). The continuous ventricular function monitor elucidated changes in left ventricular function both during exercise and recovery after exercise, as well as unmasking abnormalities in left ventricular function after coronary bypass operation.

This article has been cited by other articles:

				M. Kawasuji, T. Tedoriya, H. Takemura, N. Sakakibara, J. Taki, and Y. Watanabe Flow capacities of arterial grafts for coronary artery bypass grafting Ann. Thorac. Surg., October 1, 1993; 56(4): 957 - 962. [Abstract] [PDF]