Evaluation value of left atrial function in long-term prognosis of elderly patients with ischemic cardiomyopathy after coronary artery bypass grafting
Objective To investigate the value of left atrial function in evaluating the long-term prognosis of elderly pa-tients with ischemic cardiomyopathy(ICM)after coronary artery bypass grafting(CABG).Methods 131 elderly patients with ICM who received pre-operation cardiac magnetic resonance examination with left ventricular ejection fraction≤35%and under-went CABG in Fuwai Hospital from January 2012 to January 2017 were selected as the study subjects.Their median follow-up time was63.8 months.According to whether the major adverse cardiovascular events(MACE)occurred,they were divided into MACE group and non-MACE group.The baseline characteristics and cardiac magnetic resonance parameters were compared be-tween the two groups.Kaplan-Meier curve was used for survival analysis,and Log-rank test was used for survival comparison.Multivariate COX regression analysis was used to evaluate risk factors for MACE in elderly ICM patients.Results The maxi-mal left atrial volume index(LAVmax/BSA)of the MACE group was higher than that of the non-MACE group,and the left atrial ejection fraction of reservoir(LVEFreservoir)and left atrial ejection fraction of pump(LAEFpump)were lower than those of the non-MACE group,with statistical significance(P＜0.05).The Kaplan-Meier survival curve analysis showed that there was a statistically significant decrease in event free survival rates(P＜0.05)in the LAVmax/BSA≥46.72 mL/m2 group and the LAEFreservoir＜29.94%group.Multivariate COX regression analysis showed that LAEFreservoir[HR 0.964;95%CI(0.94,0.989),P =0.006]was independently associated with the long-term MACE after CABG in elderly ICM patients.Conclusion LAEFreservoir is an independent predictor of long-term MACE in elderly ICM patients after CABG.
elderlyischemic cardiomyopathycardiac magnetic resonanceatrial functioncoronary artery bypass grafting
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