LEFT VENTRICULAR SYSTOLIC FUNCTION AFTER CORONARY ARTERY BYPASS GRAFTING: INSIGHTS FROM GLOBAL LONGITUDINAL STRAIN AND MYOCARDIAL WORK
DOI:
https://doi.org/10.53582/vs1m5d82Keywords:
Left ventricular systolic function, GLS, Myocardial work, CABGAbstract
Introduction. Patients with multivessel coronary artery disease (CAD) and preserved left ventricular ejection fraction (LVEF) may have subclinical systolic dysfunction. Advanced echocardiographic parameters, including global longitudinal strain (GLS) and myocardial work (MW) indices, provide additional insights into myocardial performance and recovery after coronary artery bypass grafting (CABG).
Aim. To assess changes in left ventricular systolic function using conventional echocardiography, GLS, and MW indices following CABG.
Material and methods. This prospective study included 21 patients with multivessel CAD undergoing CABG. Echocardiography, including GLS, and MW indices (global work index [GWI], global constructive work [GCW], global wasted work [GWW], and global work efficiency [GWE]) was performed preoperatively and at 6-8 months postoperatively. Percentage changes and correlations were analyzed.
Results. At baseline, patients demonstrated impaired GLS and abnormal MW parameters despite preserved LVEF, consistent with subclinical LV dysfunction. At follow-up, GLS showed a statistically significant but modest improvement (p=0.021), while LVEF showed a borderline increase (p=0.078). MW indices did not change significantly at the group level but demonstrated marked inter-individual variability. GLS increased by >5% in 42.9%, and >10% in 33.3% of patients, while LVEF increased by >5% in 52.4% of patients. Improvements in GWI, GCW, and GWE were observed in approximately half of the patients. Changes in MW indices correlated with improvements in both LVEF and GLS.
Conclusion. In patients with preserved LVEF undergoing CABG, subclinical LV dysfunction is detectable using GLS and MW analysis. While structural remodeling and modest improvement in GLS were observed, MW indices showed heterogenous responses.
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Copyright (c) 2026 Elena Grueva Nastevska, Vasil Papestiev, Marjan Shokarovski, Emine Rushiti, Ana Chelikikj, Ljubica Georgievska-Ismail
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