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EFFECT OF CORONARY REVASCULARIZATION ON MYOCARDIAL CONTRACTILITY AND
PERFUSION ASSESSED BY DOBUTAMINE ECHOCARDIOGRAPHY AND TC-99M-MIBI SPECT.
Lech Paluszkiewicz, Paweł Kwinecki, Marek Jemielity, Andrzej Szyszka, Wojciech Dyszkiewicz
Instytut Kardiologii, Poznań


The aim of the study was to assess the effect of surgical revascularization (CABG) on systolic
function and perfusion of the left ventricle (LV) using dobutamine echocardiography (DE) and by
Tc-99m-MIBI SPECT (SPECT).
There were 32 patients (pts) mean age 52,2±7,2 years in whom DE and SPECT were performed
before and 3-4 months after CABG using standard protocols. Wall motion score index (WMSI) and
perfusion index (PI) were calculated.

Rest- examination at rest; D/Dip- examination after dobutamine or dipirydamole; *- p<0,006; **- p<0,002; - p<0,02; #- p<0,005; &-p<0,0002; &&-p<0,0008; $- p<0,00002
Before CABGAfter CABG
WMSIPIWMSIPI
Rest1,44±0,46*2,19±0,71&& $1,33±0,41*1,93±0,70&&
D/Di</td>1,49±0,42** 2,73±0,73& $1,39±0,44**2,20±0,69&
We noted significant improvement in WMSI and PI after CABG (Tab). We found significant
correlation between PI and WMSI at rest before CABG (r = 0,72; p<0,000005), PI after
dipirydamole and WMSI after maximal dose of Dobutamine before CABG (r = 0,47; p<0,007), PI
and WMSI at rest after CABG (r = 0,70; <0,00001), PI after dipirydamole and WMSI after
dobutamine after CABG (r = 0,66; <0,00005). We noted significant increase of PI after
dipiridamole administration before CABG in pts in whom improvement of myocardial function was
observed (2,65±0,83 vs 2,19±0,84; <0,003). In contrast, no significant increase of PI was found in
6 pts in whom myocardial function deteriorate after CABG (2,52±0,59 vs 2,07±0,43; p=0,135913).
CABG significantly improves both perfusion and contractility. Increased perfusion after CABG
correlates with improvement of systolic function of the LV.











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