B.M. Todurov, O.V. Zelenchuk, I.M. Kuzmich, N.B. Ivanyuk. Evaluation of quality of life in patients with coronary artery disease and left ventricular systolic dysfunction after coronary bypass surgery depending on the quantity of the viable myocardium

The aim – to assess quality of life and clinical status of patients with coronary artery disease (CAD) with left ventricular systolic dysfunction after revascularization, depending on the quantity of viable myocardium.

Material and methods. 179 patients with coronary heart disease with severe left ventricular dysfunction (LVEF ≤ 35 %) have been included. Isolated coronary artery bypass surgery was performed in 129 patients; 50 patients received only medical treatment. Patients were divided into three groups. The first group included 105 patients who had 30 % or more of viable myocardium, the second group – 24 patients who had viable myocardium was less than 30 % according to SPECT. The third group (control) consisted of 50 patients who received only medical treatment.

Results. Hospital mortality in the overall cohort was 3.1 %. In group I hospital mortality was 0.95 %, in group II – 12.5 %. In group I mean NYHA functional class (FC) significantly improved from 3.20±0.05 to 1.90±0.06 (Р<0.05) immediately after surgery and remained stable for three years. After 1 year, the mean value of FC in Group I was 1.50±0.07, three years later – 1.7±0.1. In group II NYHA FC improved in the early postoperative period from 3.6±0.1 to 3.4±0.1, Р>0.05. After 1 year, the mean value FC – 3.4±0.1, and three years later – 3.5±0.5. Three-year survival of patients I, II and control groups was, respectively, 81.0 %, 8.3 % and 22 % (P<0.001). In later periods after revascularization quality of life was associated with better performance (Р<0.05) in patients with myocardial viability 30 % and more. On the contrary, the patients without enough viable myocardium (less than 30 %) after surgery had lower quality of life, even compared to patients treated conservatively. Conclusion. The clinical status and quality of life was significantly better in patients with coronary heart disease with severe left ventricular dysfunction in the remote period after revascularization if quantity of viable myocardium was 30 % and more than if viable myocardium was below 30 %.

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