Multimodal Imaging Analysis and Early Outcomes of Coronary Artery Bypass Grafting in Patients with Different Ejection Fraction

Multimodal Imaging Analysis and Early Outcomes of Coronary Artery Bypass Grafting in Patients with Different Ejection Fraction | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Multimodal Imaging Analysis and Early Outcomes of Coronary Artery Bypass Grafting in Patients with Different Ejection Fraction Lini Dong, Jianfeng Long, Mu Zeng, Xiaogang Wang, Kang Zhou This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9089876/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 20 You are reading this latest preprint version Abstract Objective : To investigate the value of multimodal imaging in evaluating early postoperative outcomes in coronary artery disease (CAD) patients with different left ventricular ejection fraction (LVEF) undergoing coronary artery bypass grafting (CABG). Methods : A total of 192 patients undergoing CABG were enrolled and divided into three groups based on LVEF: normal (≥51%), reduced cardiac function(46%-50%), and low-ejection fraction groups (≤45%). Coronary computed tomography angiography (CCTA) was used to assess graft patency, and stress cardiac magnetic resonance (CMR) was performed to evaluate cardiac function, myocardial blood flow (MBF), and myocardial flow reserve (MFR) preoperatively and 6 months follow-up. Clinical characteristics, surgical risks, and imaging parameters were compared among groups. Results : The reduced LVEF group had significantly higher rates of intra-aortic balloon pump use (30.6%), unplanned conversion to cardiopulmonary bypass (13.9%), and early graft failure (25.9%) compared to the normal group ( P <0.05). Postoperatively, the low-ejection fraction group showed significant improvements in LVEF, reductions in left ventricular size and end-diastolic volume, and enhanced myocardial perfusion. However, 30-day mortality (5.6%) occurred only in this group. Multivariate analysis identified preoperative MFR in the left anterior descending artery territory (β=0.445) and NT-proBNP (β=-0.202) as independent determinants of preoperative LVEF (R²=0.552). Conclusion : Patients in both reduced cardiac function and low-ejection fraction groups achieve significant early improvements in cardiac structure, function, and myocardial perfusion after CABG, but they also face the higher intraoperative risks and challenges to graft patency. Multimodal imaging, particularly stress CMR-derived MFR, offers valuable insights for preoperative risk assessment. Coronary artery bypass grafting Ejection fractions Multimodal imaging Myocardial perfusion Cardiac magnetic resonance Full Text Additional Declarations No competing interests reported. Supplementary Files Suppl.TablesEFvalue.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 01 May, 2026 Reviews received at journal 23 Apr, 2026 Reviewers agreed at journal 22 Apr, 2026 Reviewers agreed at journal 20 Apr, 2026 Reviews received at journal 19 Apr, 2026 Reviews received at journal 17 Apr, 2026 Reviewers agreed at journal 17 Apr, 2026 Reviews received at journal 16 Apr, 2026 Reviewers agreed at journal 15 Apr, 2026 Reviewers agreed at journal 14 Apr, 2026 Reviewers agreed at journal 14 Apr, 2026 Reviews received at journal 14 Apr, 2026 Reviewers agreed at journal 14 Apr, 2026 Reviewers agreed at journal 13 Apr, 2026 Reviewers agreed at journal 08 Apr, 2026 Reviewers invited by journal 07 Apr, 2026 Editor invited by journal 18 Mar, 2026 Editor assigned by journal 16 Mar, 2026 Submission checks completed at journal 16 Mar, 2026 First submitted to journal 11 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9089876","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":620388685,"identity":"341f9750-067b-453a-a01e-361f4be7d50b","order_by":0,"name":"Lini Dong","email":"","orcid":"","institution":"Second Xiangya Hospital of Central South University","correspondingAuthor":false,"prefix":"","firstName":"Lini","middleName":"","lastName":"Dong","suffix":""},{"id":620388686,"identity":"63127bad-abb7-42a7-8ab3-bd426cde8502","order_by":1,"name":"Jianfeng Long","email":"","orcid":"","institution":"Second Xiangya Hospital of Central South 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Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Coronary artery bypass grafting, Ejection fractions, Multimodal imaging, Myocardial perfusion, Cardiac magnetic resonance","lastPublishedDoi":"10.21203/rs.3.rs-9089876/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9089876/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective\u003c/strong\u003e: To investigate the value of multimodal imaging in evaluating early postoperative outcomes in coronary artery disease (CAD) patients with different left ventricular ejection fraction (LVEF) undergoing coronary artery bypass grafting (CABG).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: A total of 192 patients undergoing CABG were enrolled and divided into three groups based on LVEF: normal (≥51%), reduced cardiac function(46%-50%), and low-ejection fraction groups (≤45%). Coronary computed tomography angiography (CCTA) was used to assess graft patency, and stress cardiac magnetic resonance (CMR) was performed to evaluate cardiac function, myocardial blood flow (MBF), and myocardial flow reserve (MFR) preoperatively and 6 months follow-up. Clinical characteristics, surgical risks, and imaging parameters were compared among groups.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: The reduced LVEF group had significantly higher rates of intra-aortic balloon pump use (30.6%), unplanned conversion to cardiopulmonary bypass (13.9%), and early graft failure (25.9%) compared to the normal group (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05). Postoperatively, the low-ejection fraction group showed significant improvements in LVEF, reductions in left ventricular size and end-diastolic volume, and enhanced myocardial perfusion. However, 30-day mortality (5.6%) occurred only in this group. Multivariate analysis identified preoperative MFR in the left anterior descending artery territory (β=0.445) and NT-proBNP (β=-0.202) as independent determinants of preoperative LVEF (R²=0.552).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: Patients in both reduced cardiac function and low-ejection fraction groups achieve significant early improvements in cardiac structure, function, and myocardial perfusion after CABG, but they also face the higher intraoperative risks and challenges to graft patency. Multimodal imaging, particularly stress CMR-derived MFR, offers valuable insights for preoperative risk assessment.\u003c/p\u003e","manuscriptTitle":"Multimodal Imaging Analysis and Early Outcomes of Coronary Artery Bypass Grafting in Patients with Different Ejection Fraction","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-13 22:54:03","doi":"10.21203/rs.3.rs-9089876/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-05-01T16:31:14+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-23T15:46:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"228098662371973871427417990063070248122","date":"2026-04-22T16:14:20+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"159612635467441098128645044788041415489","date":"2026-04-20T17:44:49+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-19T09:09:59+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-17T06:41:14+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"314786071367794353646258912678130692539","date":"2026-04-17T06:33:19+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-16T08:18:56+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"323517242919545221496356363334674997269","date":"2026-04-15T08:02:37+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"156973441169650115849561585606782058371","date":"2026-04-14T19:57:37+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"238109975291859020161624273023934474876","date":"2026-04-14T14:35:42+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-14T04:47:24+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"327241247453292355099996120050016015975","date":"2026-04-14T04:36:23+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"174976989463906315677390075518621773007","date":"2026-04-13T10:48:40+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"11599780943846994230691322896794980904","date":"2026-04-08T11:00:21+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-07T12:43:18+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-18T18:39:01+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-16T10:18:16+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-16T10:17:58+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Cardiovascular Disorders","date":"2026-03-11T04:36:44+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-cardiovascular-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcar","sideBox":"Learn more about [BMC Cardiovascular Disorders](http://bmccardiovascdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bcar/default.aspx","title":"BMC Cardiovascular Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"db842593-e205-4c7c-9904-308a5aaf13f7","owner":[],"postedDate":"April 13th, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-05-01T16:31:14+00:00","index":75,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-13T22:54:04+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-13 22:54:03","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9089876","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9089876","identity":"rs-9089876","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}