Document Detail

Relation between preoperative and intraoperative new wall motion abnormalities in vascular surgery patients: a transesophageal echocardiographic study.
MedLine Citation:
PMID:  20124982     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Coronary revascularization of the suspected culprit coronary lesion assessed by preoperative stress testing is not associated with improved outcome in vascular surgery patients. METHODS: Fifty-four major vascular surgery patients underwent preoperative dobutamine echocardiography and intraoperative transesophageal echocardiography. The locations of left ventricular rest wall motion abnormalities and new wall motion abnormalities (NWMAs) were scored using a seven-wall model. During 30-day follow-up, postoperative cardiac troponin release, myocardial infarction, and cardiac death were noted. RESULTS: Rest wall motion abnormalities were noted by dobutamine echocardiography in 17 patients (31%), and transesophageal echocardiography was noted in 16 (30%). NWMAs were induced during dobutamine echocardiography in 17 patients (31%), whereas NWMAs were observed by transesophageal echocardiography in 23 (43%), kappa value = 0.65. Although preoperative and intraoperative rest wall motion abnormalities showed an excellent agreement for the location (kappa value = 0.92), the agreement for preoperative and intraoperative NWMAs in different locations was poor (kappa value = 0.26-0.44). The composite cardiac endpoint occurred in 14 patients (26%). CONCLUSIONS: There was a poor correlation between the locations of preoperatively assessed stress-induced NWMAs by dobutamine echocardiography and those observed intraoperatively using transesophageal echocardiography. However, the composite endpoint of outcome was met more frequently in relation with intraoperative NWMAs.
Wael Galal; Sanne E Hoeks; Willem Jan Flu; Jan Peter van Kuijk; Dustin Goei; Tjebbe Galema; Corstiaan den Uil; Yvette R B M van Gestel; Jeroen J Bax; Hence J M Verhagen; Don Poldermans
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesiology     Volume:  112     ISSN:  1528-1175     ISO Abbreviation:  Anesthesiology     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-24     Completed Date:  2010-03-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  557-66     Citation Subset:  AIM; IM    
Department of Anesthesiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
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MeSH Terms
Arrhythmias, Cardiac / ultrasonography*
Cardiotonic Agents / diagnostic use
Cohort Studies
Dobutamine / diagnostic use
Echocardiography, Transesophageal*
Endpoint Determination
Heart / physiology*
Intraoperative Period
Middle Aged
Monitoring, Intraoperative
Predictive Value of Tests
Preoperative Period
Prospective Studies
Risk Assessment
Treatment Outcome
Vascular Surgical Procedures*
Ventricular Function, Left / physiology
Reg. No./Substance:
0/Cardiotonic Agents; 34368-04-2/Dobutamine
Comment In:
Anesthesiology. 2010 Mar;112(3):524-6   [PMID:  20124981 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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