Effect of graft patency on the prediction of myocardial viability by dobutamine stress and myocardial contrast echocardiography before coronary artery bypass surgery.

BackgroundMyocardial functional recovery after revascularization is considered the gold standard for myocardial viability (MV) assessment. However, the patency of the revascularized coronary artery affects myocardial functional recovery in patients subjected to coronary artery bypass grafting (CABG). The influence of graft patency on viability results has not been widely studied. PurposeWe evaluated the effect of graft patency on the prediction of MV after CABG by myocardial contrast echocardiography (MCE) and low-dose dobutamine stress echocardiography (LD-DSE). MethodsFifty-three subjects with chronic ischemic heart disease scheduled for CABG were divided randomly into groups A (n=26) and B (n=27). They underwent MCE and LD-DSE preoperatively. Patients were followed up 12 months after CABG. Group B patients underwent multislice computed tomography angiography to assess CABG patency, and patients with obstructed grafts were excluded. Group A patients were not subjected to multislice CT angiography. The accuracy of MCE and LD-DSE for assessing MV between the two groups was compared. ResultsThe accuracy and positive predictive values of MCE and LD-DSE for predicting MV were higher in group B than in group A (p<0.05). ConclusionsPreoperative LD-DSE and MCE ability to predict MV depends on the patency of CABG. (c) 2013 Wiley Periodicals, Inc. J Clin Ultrasound42:9-15, 2014