162 HFREF WITH IMPROVED EJECTION FRACTION AFTER CORONARY ARTERY BYPASS GRAFT (CABG) AND REVERSE REMODELING PREDICTOR FACTORS. (15th December 2022) - Geatti, Veronica
Abstract: Background: The purpose of this study is [1] to evaluate the incidence of heart failure with improved ejection fraction (HFimpEF) in patients with reduced ejection fraction (HFrEF, EF<40%) undergoing surgical myocardial revascularization via coronary artery bypass graft (CABG), [2] to identify predictor factors for improved ejection fraction and [3] to study overall survival between the two populations, i.e. patients with improved EF (i.e. impEF) versus patients with non-improved EF (i.e. non-impEF). Methods: N=699 patients, admitted between January 2000 and December 2020, were selected from the Cardiac Surgery database of our facility and analyzed retrospectively. The selection criteria for this study were [1] having EF<40% at the time of surgery and [2] undergoing coronary artery bypass surgery. Patients were evaluated at preoperative baseline, immediate post-operative, 3-months follow up, 1-year follow-up and the last available follow-up. ImpEF was defined as EF>40% and at least 10% EF points improvement at 1-3 months follow-up. We assessed the incidence of improved Ejection Fraction (impEF) after surgical revascularization at 3-months follow-up, defined as the improvement of Ejection Fraction from a baseline LVEF of ≤40% to a new LVEF >40%, within a measurable improvement of ≥10 points of percentage from baseline EF; predictors of impEF were investigated and the association between impEF and mortality risk was finally explored. Results: At 3-months follow-up, 221 patients were evaluated and the 42.5% (n=94) of these showed impEF. BMI, LVESVi and LVEF were predictors of impEF at multivariable analysis. ImpEF was significantly associated with better long-term survival in our cohort. Conclusions: In patients with reduced EF undergoing surgical myocardial revascularization, impEF occurs in 42.5% of cases within 3 months and is associated with better overall survival. The predictors of impEF identified in this study might be helpful in the definition of patients at higher probability of impEF before surgery.