1. Prognostic Value of Left Myocardial performance index (LVMPI) in patients undergoing CABG

2. Aim Comparison between prognostic value of global LVEF & LVMPI in patients underwent CABG

3. Methods Out of 136 patients, we studied 100 patients (78 men, 22 women ). (78 men, 22 women ). All patients had CAD without significant valvular disease. Echocardiography was done at three time interval ( before 1 month & 4 months after CABG) Patients divided to 2 groups according to LVEF: –Group A ( LVEF ≤ 40% ) –Group B ( LVEF > 40% )

4. Global LV systemic function End diastolic LV volume – End systolic LV volume End diastolic LV volume

5. LV myocardial performance index Total systolic time – Ejection time Ejection time

6. Results No mortality. No major complication such as mediastinitis. Pleural effusion ( 30% ) –Only 1/3 need to needle drainage. Atrial fibrillation ( 15% ) –All Converted to NSR by medical treatment. Myocardial infarction ( 6% ) –Which diagnosed by new Q wave and rise of cardiac enzyme.

7. Results Pericardial effusion ( 8% ) –Only 1 case need to open drainage. Sternal infection ( 3% ) –1 patient undergone thoracic surgery and 2 patients treated with conservative management. All patients had positive culture of nose discharge for staphylococcus. Leg wound infection ( 3% ) –All patients treated by oral antibiotics. Readmission due to minor complications (22%)

8. Complications

9. Risk Factors

10. Group B Group A Complications Mean LVMPI(0) Mean LVEF(0) Mean LVMPI(0) Mean LVEF(0) 0.520.500.620.37Yes AF 0.550.480.570.38No 0.580.450.530.36Yes MI 0.540.490.580.38No 0.590.480.610.35Yes Pericardial Effusion 0.540.490.570.38No 0.540.490.580.38Yes Pleural Effusion 0.550.480.580.38No 0.500.460.600.38Yes Infection 0.550.490.570.38No 0.540.480.590.37Yes Readmission 0.550.490.570.38No

11. AF Rhythm In group B, LVEF + LVMPI were not show any difference. In group A, postoperative LVEF in patients who had postoperative AF rhythm, showed less increment. In group A, pre & postoperative LVMPI in patients with AF was more.

12. Postoperative Preoperative LVEF & LVMPI had no effect on incidence of MI

13. Pericardial effusion In group B, LVEF & LVMPI had no correlation with incidence of AF. In group A, preoperative LVEF was less in patients with pericardial effusion.

14. Pleural effusion & infection No correlation was seen between preoperative LVMPI & LVEF with incidence of pleural effusion & infection.

15. Ventilation time & ICU duration In group A, patients with longer ventilation time, had lower LVEF. In group B, there was no correlation between LVEF and Ventilation time. LVMPI had no Correlation with ventilation time in both groups.

16. Conclusion Prognostic effect of LVMPI was no more than global LVEF in early and late complications.