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The effect of mild left ventricular diastolic dysfunction on outcome after isolated coronary bypass surgery.
MedLine Citation:
PMID:  24408068     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Although moderate to severe diastolic dysfunction seems to be associated with poor prognosis after isolated coronary bypass surgery, the impact of mild diastolic dysfunction is not investigated extensively in this group of patients.
AIM: We evaluated the prognostic implication of mild left ventricular diastolic dysfunction on outcome after isolated coronary bypass surgery in patients with preserved left ventricular systolic function.
METHODS: Data of 650 patients undergoing isolated coronary bypass surgery and having records for left ventricular diastolic function between January 2009 and August 2011 was collected retrospectively. Diastolic dysfunction was classified as mild (grade 1, impaired relaxation), moderate (grade 2, decreased compliance) and severe (grade 3-4, restrictive pattern) depending on mitral inflow wave, tissue Doppler imaging, and pulmonary vein flow wave. Patients with baseline rhythm other than sinus, moderate or severe valvular dysfunction, moderate or severe diastolic dysfunction and left ventricle ejection fraction lower than 50% were excluded. A total of 472 patients were identified within the database fulfilling the eligibility criteria for this analysis and stratified according to the echocardiographic findings as follows: group 1, patients with normal diastolic function (n=168) and group 2, patients with mild diastolic dysfunction (impaired relaxation) (n=304). These groups were compared for perioperative morbidity and mortality.
RESULTS: The preoperative variables were comparable between groups. The outcome parameters of group 1 was similar when compared to group 2 in means of need for inotropic support (20.2% vs. 16.2%), intra-aortic balloon pump usage (0% vs 1.4%), mechanical ventilation time (hours) (8.94 ±0.96 vs 10.0 ±0.89), reintubation rate (1.8% vs 1.4%), intensive care unit stay time (hours) (24.1±1.4 vs 26.2±1.9), postoperative renal failure rate (0% vs 0.3%), postoperative atrial fibrillation rate (10.1% vs 11.2%), length of hospital stay (days) (7.19± 0.45 vs 6.57 ± 0.14), hospital readmission rate (3.1% vs. 3.1%), and mortality (0% vs 1.6%).
CONCLUSIONS: The results from this study indicate that mild left ventricular diastolic dysfunction is not associated with adverse outcome after coronary bypass surgery in patients with preserved left ventricular systolic function, thus should not be considered as a preoperative risk factor.
Authors:
Aleks Değirmencioğlu; Sahin Senay; Umit Güllü; Ertuğrul Zencirci; Gültekin Karakuş; Murat Ugur; Ali Buturak; Cem Alhan
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-1-10
Journal Detail:
Title:  Kardiologia polska     Volume:  -     ISSN:  0022-9032     ISO Abbreviation:  Kardiol Pol     Publication Date:  2014 Jan 
Date Detail:
Created Date:  2014-1-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376352     Medline TA:  Kardiol Pol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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