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J Thorac Cardiovasc Surg 2004;128:76-82
© 2004 The American Association for Thoracic Surgery

Cardiopulmonary support and physiology

Ventricular function after coronary artery bypass grafting: Evaluation by magnetic resonance imaging and myocardial strain analysis

Hersh S. Maniar, MDa, Brian P. Cupps, PhDa, D. Dean Potter, MDb, Pavlos Moustakidis, MDa, Cindy J. Camillo, ANPa, Celeste M. Chu, BSa, Michael K. Pasque, MDa, Thoralf M. Sundt, III, MDb,*

a Division of Cardiothoracic Surgery, Washington University School of Medicine, St Louis, Mo, USA
b Division of Cardiothoracic Surgery, The Mayo Clinic, Rochester, Minn, USA

Received for publication May 28, 2002; revisions received September 5, 2003; accepted for publication October 6, 2003.

* Address for reprints: Thoralf M, Sundt III, MD, Division of Cardiovascular Surgery, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
sundt.thoralf{at}mayo.edu

OBJECTIVE: Magnetic resonance imaging with radiofrequency tissue tagging permits quantitative assessment of regional systolic myocardial strain. We sought to investigate the utility of this imaging modality to quantitatively determine preoperative impairment and postoperative improvement in ventricular function in patients with ischemic heart disease.

METHODS: Magnetic resonance imaging with radiofrequency tissue tagging was performed on 6 patients (average age 60.2 ± 13.7 years) with coronary artery disease and 32 control subjects with no known heart disease. Patients with coronary artery disease underwent imaging before and 3 months after coronary artery bypass grafting. The ventricle was divided into 6 segments within a midventricular plane. Regional 2-dimensional left ventricular circumferential strain was calculated from tagged magnetic resonance images throughout systole. Circumferential strain results were compared in patients before and after and 3 months after coronary artery bypass grafting and also in control subjects.

RESULTS: Before the operation circumferential strain identified 100% (10/10) of all regional wall motion abnormalities seen by preoperative ventriculography. Postoperatively, improvements were demonstrated in 56% (20/36) of the regions, and these improvements agreed with viability testing by single-photon emission computed tomography when available. Additionally, preoperative global circumferential strain for the ischemic group was significantly depressed relative to that in control subjects (0.11 ± 0.05 vs 0.20 ± 0.03, P < .001). Global circumferential strain correlated with ejection fraction by ventriculography (r = 0.84, P < .01) and improved after coronary artery bypass grafting (0.14 ± 0.05 vs 0.11 ± 0.05, P < .01).

CONCLUSIONS: Magnetic resonance imaging with radiofrequency tissue tagging permitted circumferential strain calculation. This technology quantitatively demonstrated improvements in left ventricular wall motion after coronary artery bypass grafting for both individual regions and the entire ventricle. This noninvasive method may prove useful in preoperative evaluation and postoperative serial assessment of left ventricular wall motion.




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D. D. Potter, P. A. Araoz, K. P. McGee, W. S. Harmsen, J. N. Mandrekar, and T. M. Sundt III
Low-dose dobutamine cardiac magnetic resonance imaging with myocardial strain analysis predicts myocardial recoverability after coronary artery bypass grafting.
J. Thorac. Cardiovasc. Surg., June 1, 2008; 135(6): 1342 - 1347.
[Abstract] [Full Text] [PDF]


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