Change in Left Ventricular Peak Global Longitudinal Strain in Patients Undergoing Uneventful On-Pump Coronary Artery Bypass Grafting Surgery

Objectives Immediately after coronary artery bypass grafting (CABG) surgery, the left ventricular (LV) function measured by peak LV global longitudinal strain (GLS) is influenced by general anesthesia, positive pressure ventilation, myocardial protection technique used, the effect of myocardial revascularization, and the effect of inotropic and vasopressor agent used. Therefore, we intended to perform a study evaluating the change in the LV function, measured by peak LV GLS, from the immediate post-operative period to the immediate pre-hospital discharge period (7–10 days after surgery) in patients undergoing uneventful, on-pump CABG surgery and having an uneventful early post-operative course. Material and Methods In patients aged 30–65 years, having LV ejection fraction (LVEF) >50%, undergoing elective, multiple (>2) graft, on-pump CABG surgery by a single surgeon and having uneventful post-operative course, peak LV GLS was measured in the immediate post-operative period by TEE and at the time of hospital discharge (post-operative day 7–10) by transthoracic echocardiography. The association between the change in the peak LV GLS and the vasoactive inotropic score (VIS) in the immediate post-operative period was also checked. Results Analysis of data from 51 participants revealed a significant decline in peak LV GLS from −12.8 ± 3.8% (mean ± standard deviation [SD]) in the immediate post-operative period to −10.2±2.4% (mean ± SD) in the immediate pre-discharge period ( P = 0.000). Heart rate and cardiac index decreased significantly, while mean arterial pressure and systemic vascular resistance index increased significantly from the immediate post-operative period to the immediate pre-discharge period. Conclusion Low-risk patients with normal LVEF undergoing multivessel CABG surgery with uneventful intraoperative and early post-operative (during index hospital stay) course have a significant decline in peak LV GLS from the immediate intraoperative period. This decline is not significantly associated with either immediate pre-operative peak LV GLS or VIS in the immediate post-operative period.