Influence of wall motion score on mortality after coronary bypass surgery in the CABG-patch trial

Frank Jung, John M. Herre, Mark A. Wood, Susan O'Donoghue, David S. Cannom, John Robert Windle, Thomas Hilbel, Deepak R. Talreja, Michael K. Parides, J. Thomas Bigger, John P. DiMarco

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Abstract

Background: It was hypothesized that a wall motion score (WMS) of ≤16% determined by chordal analysis (WMS=% of chords analyzed with normal or hyperkinetic motion) from a right anterior oblique (RAO) left ventriculogram would be a predictor for perioperative (30-day or in-hospital) or long-term mortality in patients from the CABG-Patch Trial. Methods and results: One hundred and eighty-nine patients from the trial with a LVEF of ≤36% were retrospectively studied. Patients were divided into two groups according to a WMS of ≤16% (n=81) or >16% (n=108), respectively, calculated from a preoperative RAO ventriculogram. There was no difference in EF between the two groups (26.5±5.5 vs. 27.8±5.3%, respectively). Eight (9.9%) versus three (2.8%) patients died perioperatively in the low versus the high WMS group, respectively. The relative risk for perioperative death in the low WMS group was 3.6 (P<0.04). Kaplan-Meier estimates of cumulative survival did not reveal any statistical difference between the two groups over 4 years (P=0.11). Subgroup analysis revealed that patients with a WMS of ≤16% had a better survival when treated with an ICD at the time of surgery compared to those not treated with an ICD (P=0.046). Conclusions: These data indicate that poor LV function, as assessed by a WMS of ≤16%, can identify a subgroup of low EF patients who are at increased risk for perioperative mortality after bypass surgery. Conversely, long-term estimates of survival in patients with WMS ≤16 and >16% were not significantly different, although subgroup analysis revealed that patients with a WMS ≤16% may benefit from implantation of an ICD at the time of surgery.

Original languageEnglish (US)
Pages (from-to)41-47
Number of pages7
JournalInternational Journal of Cardiology
Volume82
Issue number1
DOIs
StatePublished - Jan 31 2002

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Keywords

  • Coronary revascularization
  • Implantable defibrillators
  • Left ventricular function
  • Wall motion score

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Influence of wall motion score on mortality after coronary bypass surgery in the CABG-patch trial. / Jung, Frank; Herre, John M.; Wood, Mark A.; O'Donoghue, Susan; Cannom, David S.; Windle, John Robert; Hilbel, Thomas; Talreja, Deepak R.; Parides, Michael K.; Bigger, J. Thomas; DiMarco, John P.

In: International Journal of Cardiology, Vol. 82, No. 1, 31.01.2002, p. 41-47.

Research output: Contribution to journalArticle

Jung, F, Herre, JM, Wood, MA, O'Donoghue, S, Cannom, DS, Windle, JR, Hilbel, T, Talreja, DR, Parides, MK, Bigger, JT & DiMarco, JP 2002, 'Influence of wall motion score on mortality after coronary bypass surgery in the CABG-patch trial', International Journal of Cardiology, vol. 82, no. 1, pp. 41-47. https://doi.org/10.1016/S0167-5273(01)00587-3
Jung, Frank ; Herre, John M. ; Wood, Mark A. ; O'Donoghue, Susan ; Cannom, David S. ; Windle, John Robert ; Hilbel, Thomas ; Talreja, Deepak R. ; Parides, Michael K. ; Bigger, J. Thomas ; DiMarco, John P. / Influence of wall motion score on mortality after coronary bypass surgery in the CABG-patch trial. In: International Journal of Cardiology. 2002 ; Vol. 82, No. 1. pp. 41-47.
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abstract = "Background: It was hypothesized that a wall motion score (WMS) of ≤16{\%} determined by chordal analysis (WMS={\%} of chords analyzed with normal or hyperkinetic motion) from a right anterior oblique (RAO) left ventriculogram would be a predictor for perioperative (30-day or in-hospital) or long-term mortality in patients from the CABG-Patch Trial. Methods and results: One hundred and eighty-nine patients from the trial with a LVEF of ≤36{\%} were retrospectively studied. Patients were divided into two groups according to a WMS of ≤16{\%} (n=81) or >16{\%} (n=108), respectively, calculated from a preoperative RAO ventriculogram. There was no difference in EF between the two groups (26.5±5.5 vs. 27.8±5.3{\%}, respectively). Eight (9.9{\%}) versus three (2.8{\%}) patients died perioperatively in the low versus the high WMS group, respectively. The relative risk for perioperative death in the low WMS group was 3.6 (P<0.04). Kaplan-Meier estimates of cumulative survival did not reveal any statistical difference between the two groups over 4 years (P=0.11). Subgroup analysis revealed that patients with a WMS of ≤16{\%} had a better survival when treated with an ICD at the time of surgery compared to those not treated with an ICD (P=0.046). Conclusions: These data indicate that poor LV function, as assessed by a WMS of ≤16{\%}, can identify a subgroup of low EF patients who are at increased risk for perioperative mortality after bypass surgery. Conversely, long-term estimates of survival in patients with WMS ≤16 and >16{\%} were not significantly different, although subgroup analysis revealed that patients with a WMS ≤16{\%} may benefit from implantation of an ICD at the time of surgery.",
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AU - Jung, Frank

AU - Herre, John M.

AU - Wood, Mark A.

AU - O'Donoghue, Susan

AU - Cannom, David S.

AU - Windle, John Robert

AU - Hilbel, Thomas

AU - Talreja, Deepak R.

AU - Parides, Michael K.

AU - Bigger, J. Thomas

AU - DiMarco, John P.

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