Effects of myocardial revascularization on diastolic function and left ventricular myocardial strain in the early period after coronary artery bypass grafting in patients with coronary heart disease ans type 2 diabetes mellitus
Objective. To investigate impact of myocardial revascularization by coronary bypass surgery on diastolic function and left ventricle myocardial deformation in patients with stable coronary artery disease and diabetes mellitus type 2 during early postoperative period. Material and methods. 40 patients with stable coronary artery disease took part in the study. The patients were divided into 2 groups. Group 1 included 20 patients without diabetes mellitus, 50% of them experienced myocardial infarction. Group 2 included 20 patients with diabetes mellitus type 2; 50% of them experienced myocardial infarction. Average age of the patients in this study was 57.2±8.6 years. All patients had undergone global and segmental evaluation of systolic and diastolic left ventricle myocardial function prior coronary bypass surgery and during early postoperative period. A glycemic control and an analysis of its impact on changeable indexes were also evaluated. Results. Diastolic left ventricle myocardial dysfunction was detected in 65% with stable IHD and in 85% of patients with IHD and with metabolic disorder. The most spread type of left ventricle diastolic dysfunction was slow relaxation (type 1) - 60% of cases without diabetes and in 80% of cases with diabetes mellitus type 2. Deformation and deformation speed is slowed down in both patients groups in all segments ( р <0.05); especially in basal segment ( р <0.01) and is in direct interrelation with affected coronary arteries localization. An improvement of deformation index and deformation speed in all segments of revasculated myocardium was detected in both patients with and without diabetes mellitus during early postoperative period. Conclusion. The defects of segmentary systolic and diastolic left ventricle myocardium function in patients with stable coronary artery disease are partially inversive after coronary revascularization by coronary bypass grafting. Moreover, negative impact of diabetes mellitus type 2 on deformation indexes in early postoperative period after coronary bypass grafting was not revealed.