prognostic value of left myocardial performance index (lvmpi) in patients undergoing cabg

Prognostic Value of Left Myocardial performance index (LVMPI) in patients

undergoing CABG

Aim

Comparison between prognostic value of global LVEF & LVMPI in patients underwent CABG

Methods

Out of 136 patients, we studied 100 patients (78 men, 22 women ).

All patients had CAD without significant valvular disease. Echocardiography was done at three time interval ( before 1 month & 4 months after CABG) Patients divided to 2 groups according to LVEF:– Group A ( LVEF ≤ 40% )– Group B ( LVEF > 40% )

Global LV systemic function

End diastolic LV volume – End systolic LV volume

End diastolic LV volume

LV myocardial performance index

Total systolic time – Ejection time

Ejection time

Results

No mortality.No major complication such as mediastinitis.Pleural effusion ( 30% )– Only 1/3 need to needle drainage.

Atrial fibrillation ( 15% )– All Converted to NSR by medical treatment .

Myocardial infarction ( 6% )– Which diagnosed by new Q wave and rise of

cardiac enzyme.

ResultsPericardial effusion ( 8% )– Only 1 case need to open drainage.

Sternal infection ( 3% )– 1 patient undergone thoracic surgery and 2 patients

treated with conservative management. All patients had positive culture of nose discharge for staphylococcus.

Leg wound infection ( 3% ) – All patients treated by oral antibiotics.

Readmission due to minor complications (22%)

Complications

0

5

10

15

20

25

30

35

40

Group A Group B

AF

MI

Per. Effu.

Pleu. Effu.

Inf.

Re-admi.

Risk Factors

0

10

20

30

40

50

60

70

Group A Group B

DMHTNHigh LDLHigh TGCS+FH

Group B Group AComplicationsMean

LVMPI(0)Mean

LVEF(0)Mean

LVMPI(0)Mean

LVEF(0)

0.52 0.50 0.62 0.37 YesAF

0.55 0.48 0.57 0.38 No

0.58 0.45 0.53 0.36 YesMI

0.54 0.49 0.58 0.38 No

0.59 0.48 0.61 0.35 Yes Pericardial Effusion0.54 0.49 0.57 0.38 No

0.54 0.49 0.58 0.38 YesPleural Effusion

0.55 0.48 0.58 0.38 No

0.50 0.46 0.60 0.38 YesInfection

0.55 0.49 0.57 0.38 No

0.54 0.48 0.59 0.37 YesReadmission

0.55 0.49 0.57 0.38 No

AF Rhythm

In group B, LVEF + LVMPI were not show any difference.

In group A, postoperative LVEF in patients who had postoperative AF rhythm, showed less increment.

In group A, pre & postoperative LVMPI in patients with AF was more.

Postoperative

Preoperative LVEF & LVMPI had no effect on incidence of MI

Pericardial effusion

In group B, LVEF & LVMPI had no correlation with incidence of AF.

In group A, preoperative LVEF was less in patients with pericardial effusion.

Pleural effusion & infection

No correlation was seen between preoperative LVMPI & LVEF with incidence of pleural effusion & infection.

Ventilation time & ICU duration

In group A, patients with longer ventilation time, had lower LVEF.

In group B, there was no correlation between LVEF and Ventilation time.

LVMPI had no Correlation with ventilation time in both groups.

Conclusion

Prognostic effect of LVMPI was no more than global LVEF in early and late complications.