Prognostic value of a tissue Doppler-derived index of left ventricular filling pressure on composite morbidity after off-pump coronary artery bypass surgery
Prognostic value of a tissue Doppler-derived index of left ventricular filling pressure on composite morbidity after off-pump coronary artery bypass surgery
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DOI：
10.1093/bja/aer188
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发表时间：
2011-10-01
影响因子：
9.8
通讯作者：
Kwak, Y. L.
中科院分区：
文献类型：
--
作者：
Jun, N. H.;Shim, J. K.;Kwak, Y. L.
背景。早期二尖瓣血流速度与二尖瓣环舒张早期速度之比 (E/e') 是舒张功能的指标，与左心室 (LV) 充盈压密切相关，并且相对独立于收缩功能和节律异常。我们前瞻性评估了 E/e' 对接受非体外循环冠状动脉搭桥手术 (OPCAB) 的患者术后结果的预测价值。方法。接受 OPCAB 的患者根据 E/e' 比率分为三组： (i) 正常 E/e',8； (ii) 未确定的 E/e' >= 8 和 15、高左室充盈压、左室射血分数、纽约心脏协会 III 级和 IV 级以及利尿剂的使用是术后发病的重要危险因素。在这些变量的多变量回归分析中，只有 sCr（优势比 1.4）和 E/e' >15（优势比 2.4）或高左心室充盈压（优势比 2.8）仍然是独立危险因素。结论。 E/e' 比率 >15 是术后发病率复合终点的重要预测因子。我们建议 E/e' 比值应纳入 OPCAB 患者的常规术前评估中。
Background. The ratio of early transmitral flow velocity to early diastolic velocity of the mitral annulus (E/e') is an indicator of diastolic function that correlates well with left ventricular (LV) filling pressure and is relatively independent of systolic function and rhythm abnormalities. We prospectively evaluated the predictive value of E/e' for postoperative outcome in patients undergoing off-pump coronary artery bypass graft surgery (OPCAB).Methods. Patients undergoing OPCAB were classified into three groups according to their E/e' ratio: (i) normal E/e',8; (ii) undetermined E/e' >= 8 and 15, high LV filling pressure, LV ejection fraction, New York Heart Association class III and IV, and use of diuretics were significant risk factors for postoperative morbidity. In multivariate regression analysis of these variables, only sCr (odds ratio 1.4) and E/e' >15 (odds ratio 2.4) or high LV filling pressure (odds ratio 2.8) remained as independent risk factors.Conclusions. E/e' ratio >15 was a significant predictor of composite endpoints of postoperative morbidity. We suggest that E/e' ratio should be included in the routine preoperative assessment of patients presenting for OPCAB.