Effect of coronary artery bypass graft in patients with unstable angina on left ventricular remodelling in medium-term follow-up.

INTRODUCTION: Left ventricular remodelling is a process of change in size, shape, wall thickness and heart function, initiated by a noxious stimulus such as ischaemia. Methods of pharmacological and surgical inhibition or reversal of remodelling are being sought. AIM: To assess the influence of coronary artery bypass grafting on echocardiographic measures of left ventricular size and shape in medium-term follow-up. METHODS: In a group of 30 patients three echocardiographic examinations were performed: before CABG operation, 3 months after and 20 months after the operation. Left ventricular area and volumes as well as indices of sphericity, thinning and expansion were calculated. RESULTS: After the operation, left ventricular areas measured in short axis and in apical four-chamber view increased among patients with a history of myocardial infarction. Improvement in the sphericity index occurred after the operation in patients with a history of myocardial infarction in whom the ejection fraction before the operation was less than 50%. CONCLUSIONS: The left ventricular remodelling process progresses after coronary artery bypass grafting in patients with a history of myocardial infarction. Inhibition of remodelling may be expected in patients without myocardial infarction, with preserved left ventricular systolic function.