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Diastolic function and new-onset atrial fibrillation following cardiac surgery

BACKGROUND: Numerous studies have reported predictors of new-onset postoperative atrial fibrillation (POAF) following cardiac surgery, which is associated with increased length of stay, cost of care, morbidity, and mortality. The purpose of this study was to examine the association between preoperat...

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Autores principales: Barbara, David W., Rehfeldt, Kent H., Pulido, Juan N., Li, Zhuo, White, Roger D., Schaff, Hartzell V., Mauermann, William J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4900315/
https://www.ncbi.nlm.nih.gov/pubmed/25566703
http://dx.doi.org/10.4103/0971-9784.148313
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author Barbara, David W.
Rehfeldt, Kent H.
Pulido, Juan N.
Li, Zhuo
White, Roger D.
Schaff, Hartzell V.
Mauermann, William J.
author_facet Barbara, David W.
Rehfeldt, Kent H.
Pulido, Juan N.
Li, Zhuo
White, Roger D.
Schaff, Hartzell V.
Mauermann, William J.
author_sort Barbara, David W.
collection PubMed
description BACKGROUND: Numerous studies have reported predictors of new-onset postoperative atrial fibrillation (POAF) following cardiac surgery, which is associated with increased length of stay, cost of care, morbidity, and mortality. The purpose of this study was to examine the association between preoperative diastolic function and occurrence of new-onset POAF in patients undergoing a variety of cardiac surgeries at a single institution. METHODS: Using data from a prospective study from November 2007 to January 2010, a retrospective review was conducted. The diastolic function of each patient was determined from preoperative transthoracic echocardiograms. Occurrence of new-onset POAF was prospectively noted for each patient in the original study. Demographic and operative characteristics of the study population were analyzed to determine predictors of POAF. RESULTS: Of 223 patients, 91 (40.8%) experienced new-onset POAF. Univariate predictors of POAF included increasing age, male gender, operations involving mitral valve repair/replacement, nonsmoking, hypertension, increased intraoperative pulmonary artery pressure, grade I diastolic dysfunction, abnormal diastolic function of any grade, decreased medial e’, elevated medial E/e’, and increased left atrial volume. Multivariate predictors of POAF included increasing age, increased left atrial volume, and elevated initial intraoperative pulmonary artery pressure. Even after exclusion of patients with hypertrophic obstructive cardiomyopathy or those undergoing mitral valve operations, diastolic dysfunction was not a multivariate predictor of POAF. CONCLUSIONS: In the patient population studied here, preoperative diastolic dysfunction was not predictive of POAF. In addition to increasing age, initial intraoperative pulmonary artery systolic pressure and left atrial volume were both significant multivariate predictors of POAF.
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spelling pubmed-49003152016-06-16 Diastolic function and new-onset atrial fibrillation following cardiac surgery Barbara, David W. Rehfeldt, Kent H. Pulido, Juan N. Li, Zhuo White, Roger D. Schaff, Hartzell V. Mauermann, William J. Ann Card Anaesth Original Article BACKGROUND: Numerous studies have reported predictors of new-onset postoperative atrial fibrillation (POAF) following cardiac surgery, which is associated with increased length of stay, cost of care, morbidity, and mortality. The purpose of this study was to examine the association between preoperative diastolic function and occurrence of new-onset POAF in patients undergoing a variety of cardiac surgeries at a single institution. METHODS: Using data from a prospective study from November 2007 to January 2010, a retrospective review was conducted. The diastolic function of each patient was determined from preoperative transthoracic echocardiograms. Occurrence of new-onset POAF was prospectively noted for each patient in the original study. Demographic and operative characteristics of the study population were analyzed to determine predictors of POAF. RESULTS: Of 223 patients, 91 (40.8%) experienced new-onset POAF. Univariate predictors of POAF included increasing age, male gender, operations involving mitral valve repair/replacement, nonsmoking, hypertension, increased intraoperative pulmonary artery pressure, grade I diastolic dysfunction, abnormal diastolic function of any grade, decreased medial e’, elevated medial E/e’, and increased left atrial volume. Multivariate predictors of POAF included increasing age, increased left atrial volume, and elevated initial intraoperative pulmonary artery pressure. Even after exclusion of patients with hypertrophic obstructive cardiomyopathy or those undergoing mitral valve operations, diastolic dysfunction was not a multivariate predictor of POAF. CONCLUSIONS: In the patient population studied here, preoperative diastolic dysfunction was not predictive of POAF. In addition to increasing age, initial intraoperative pulmonary artery systolic pressure and left atrial volume were both significant multivariate predictors of POAF. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4900315/ /pubmed/25566703 http://dx.doi.org/10.4103/0971-9784.148313 Text en Copyright: © 2015 Annals of Cardiac Anaesthesia http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Barbara, David W.
Rehfeldt, Kent H.
Pulido, Juan N.
Li, Zhuo
White, Roger D.
Schaff, Hartzell V.
Mauermann, William J.
Diastolic function and new-onset atrial fibrillation following cardiac surgery
title Diastolic function and new-onset atrial fibrillation following cardiac surgery
title_full Diastolic function and new-onset atrial fibrillation following cardiac surgery
title_fullStr Diastolic function and new-onset atrial fibrillation following cardiac surgery
title_full_unstemmed Diastolic function and new-onset atrial fibrillation following cardiac surgery
title_short Diastolic function and new-onset atrial fibrillation following cardiac surgery
title_sort diastolic function and new-onset atrial fibrillation following cardiac surgery
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4900315/
https://www.ncbi.nlm.nih.gov/pubmed/25566703
http://dx.doi.org/10.4103/0971-9784.148313
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