Purpose: to evaluate QOL, LV diastolic function parameters and brain natriuretic peptide (BNP) in patients with CAD and preserved or mid-range LVEF before and 6 months after CABG.
Methods. The cross-sectional single-center retrospective study included data from clinical and instrumental examination of 71 patients with CAD and preserved or mid-range systolic function (LVEF =40%), consecutively selected for CABG. Among them, there were 60 men and 11 women aged 57 to 70 years, middle age (64±4) years. 11 (17%) patients had signs of stable angina ?I functional class (FC), 44 (69%) had III FC, 9 (14%) – IV FC. We analyzed FC of angina, QOL parameters by using SF-36, Seattle Angina Questionnaire (SAQ), the Minnesota Living with Heart Failure Questionnaire (MLHFQ), the echocardiographic parameters and the BNP level before and 6 months after CABG.
Results. Six months after CABG a significant improvement of QOL was registered by questionnaires MLHFQ, SF-36 and SAQ, compared to baseline (p <0,001), including the scales of the frequency of angina attacks, physical and emotional functioning, mental health and manifestations of heart failure. The angina symptoms significantly decreased: there were no angina attacks in 38 (59%) patients, and I and II FC were observed in 25 (39%) patients (p <0,001). Reduced FC by 2 or more grades was registered in 45 (70%) patients after CABG. Six months after surgery, there was a significant improvement in LV diastolic function, namely reduction of DT from median 262 (quartiles 223-296) ms to 250 (220-280) ms (p <0,001), IVRT from 118 (109-125) ms to 112 (105-115) ms (p = 0,021), and increase of E/A from 0,82 (0,73-0,93) to 0,92 (0,76-0,99) ( p = 0,043). The BNP level decreased from 115,4 (62,0-150,6) pg/ml to 52,4 (20,4-95,9) pg/ml (p <0,001).
Conclusion. Reducing angina pectoris and improving parameters of QOL 6 months after CABG is associated with positive changes of LV diastolic function parameters and decrease of BNP.