การใช้คลื่นไฟฟ้าหัวใจแบบเฉลี่ยสัญญาณเพื่อทำนายการเปลี่ยนแปลงการทำงานของหัวใจห้องล่างซ้ายในผู้ป่วยโรคหลอดเลือดโคโรนารีที่มีการทำงานของหัวใจห้องล่างซ้ายผิดปกติหลังการผ่าตัดรักษาโรคหลอดเลือดหัวใจตีบที่ระยะเวลา 3 เดือน / สุชัย กาญจนธารายนตร์ = Signal-Averaged electrocardiogram predicts change in left ventricular ejection fraction at 3 month: After coronary artery bypas graft surgery in coronary artery disease patients with left ventricular dysfunction / Suchai Kanjanatarayont
Coronary artery disease (CAD) patients with LV dysfunction who underwent coronary artery bypass graft surgery (CABG) had improved survival when compared to patients treated with medical therapy alone. The survival advantage in the CABG group may be related to improved postoperative left ventricular ejection fraction (LVEF). A simple test, signal-averaged electrocardiogram (SAECG), was used to assess viability of myocardium on the basis of positive (abnormal) SAECG reflected lower residual viability indirectly which function did not recover function after CABG compared to those with negative (normal) SAECG. So this study test the hypothesis that positive SAECG patients have less improvement in LVEF than those with negative SAECG patients at 3 months after CABG. All patients who have CAD with LV dysfunction (LVEF<0.36) and who were scheduled for elective CABG at Chulalongkorn hospital, SAECG and LVEF measurement by MUGA technique were performed preoperatively and 3 month postoperatively. The patients were classified into positive and negative SAECG by standard criteria of positive SAECG. 20 patients were studied completely, 6 patients were in the positive group and 14 patients in the negative group. Baseline characteristics were almost similar except for sex and cardiac medications. Overall, the LVEF improvement was 35& postoperatively with a significantly greater benefit in the negative SAECG group. (14±11-point vs 4±3 -point increase ,p 0.02) The study showed the predictive value of SAEGC in identifying CAD patients with LV who underwent elective CABG with greater improvement in LVEF.