Upright bicycle exercise echocardiography after coronary artery bypass grafting

• Published in: The American journal of cardiology Vol. 64; no. 18; pp. 1123 - 1129
• Main Authors: Sawada, Stephen G., Judson, Walter E., Ryan, Thomas, Armstrong, William F., Feigenbaum, Harvey
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 15-11-1989; Elsevier
• Subjects: Adult; Aged; Biological and medical sciences; Coronary Angiography; Coronary Artery Bypass; Coronary Disease - diagnosis; Coronary Vessels - pathology; Echocardiography; Exercise Test; Female; Heart - physiology; Humans; Male; Medical sciences; Middle Aged; Myocardial Revascularization; Sensitivity and Specificity; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Vascular Patency; Heart; Human; Echocardiography; Coronary artery; Bicycle ergometer; Cardiovascular disease; Screening; Aortocoronary; Bypass; Surgery; Blood vessel; Exercise tolerance test; Repermeabilization
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/0002-9149(89)90864-3

Upright bicycle exercise echocardiography and coronary angiography were performed in 42 patients from 1 month to 15 years (mean 6.3 years) after coronary artery bypass grafting (CABG) to determine if exercise-induced wall motion abnormalities could be correlated with the presence and location of nonrevascularized vessels. Nonrevascularized vessels were defined as obstructed vessels without grafts, obstructed grafts or native vessels obstructed distal to bypass graft insertion. Adequate quality echocardiograms were recorded at rest, peak exercise and after exercise in 38 patients (90%). Rest and postexercise echocardiograms were adequate in 3 others. Only 1 patient was excluded from analysis for inadequate peak and postexercise echocardiograms. Exercise-induced wall motion abnormalities were present in 33 of 35 patients (94%) who had 1 or more nonrevascularized vessels and these abnormalities were absent in 5 of 6 (83%) who had all vessels revascularized. Wall motion abnormalities were localized to the territory of the left anterior descending (LAD) artery or to a combined right (R) coronary-left circumflex (LC) region of circulation. Exercise-induced wall motion abnormalities were present in 24 of 27 LAD artery regions (89%) and 23 of 26 R-LC regions (88%) that had nonrevascularized vessels. These abnormalities were absent in 13 of 14 LAD regions (93%) and in 12 of 15 R-LC regions (80%) that had only revascularized vessels. Upright bicycle exercise echocardiography was successfully performed after CABG. The technique detected and accurately localized nonrevascularized and revascularized vessels.