1. Changes in cardiac functional capacity after coronary bypass surgery in relation to adequacy of revascularization
- Author
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Fusako Kusumi, Kenneth F. Hossack, Robert A. Bruce, and Tom D. Ivey
- Subjects
Male ,medicine.medical_specialty ,Cardiac output ,medicine.medical_treatment ,Adrenergic beta-Antagonists ,Revascularization ,Fick principle ,Angina Pectoris ,Angina ,Oxygen Consumption ,Heart Rate ,Internal medicine ,Heart rate ,medicine ,Humans ,Cardiac Output ,Coronary Artery Bypass ,Aged ,business.industry ,Heart ,Stroke Volume ,Stroke volume ,Middle Aged ,medicine.disease ,Oxygen ,Bypass surgery ,Anesthesia ,Cardiology ,Exercise Test ,Female ,Maximal exercise ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Seventy patients having aortocoronary vein bypass grafting surgery for angina pectoris underwent preoperative invasive exercise testing to symptom limits and again 6 to 14 months postoperatively. Cardiac output was measured using the direct Fick principle. Postoperatively at maximal exercise, there was a 3.11 liters/min (p less than 0.0001) increase in cardiac output in men (n = 61) and a 2.04 liters/min (p less than 0.01) increase in women (n = 9). Patients with complete revascularization showed a significantly greater improvement in cardiac output postoperatively than did those with incomplete revascularization (26 versus 6%, p less than 0.0001). The major reason for the increased maximal cardiac output was a marked increase in heart rate while stroke volume was maintained at the same preoperative level. These findings were true irrespective of preoperative use of beta-adrenergic blocking drugs.
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