Prognostic value of tissue Doppler-Derived E/e' on early morbid events after cardiac surgery.
Prognostic value of tissue Doppler-Derived E/e' on early morbid events after cardiac surgery.
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DOI：
10.1111/j.1540-8175.2009.01076.x
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发表时间：
2010-02
期刊：
影响因子：
--
通讯作者：
Kincaid EH
中科院分区：
文献类型：
--
作者：
Groban L;Sanders DM;Houle TT;Antonio BL;Ntuen EC;Zvara DA;Kon ND;Kincaid EH
组织多普勒衍生的左心室舒张压替代物E/e′已被用于对各种心血管疾病的结果进行预测。在这项研究中，我们确定了需要心脏手术的患者术中E/e′与正性肌力支持的使用、机械通气（MV）持续时间、重症监护病房住院时间（ICU-LOS）和总住院时间（H-LOS）的关系。回顾性分析了245例连续患者的记录，以获得205例在冠状动脉旁路移植术（CABG）和/或瓣膜手术前接受术中经食管超声心动图（TEE）检查的患者。采用考克斯比例风险和逻辑回归模型分析术中E/e′或LVEF与术后早期发病率（H-LOS、ICU-LOS和MV）之间的关系，以及患者需要正性肌力支持的概率。对其他预测因素进行调整后（女性、高血压、糖尿病、心肌梗死史、急诊手术、肾功能衰竭、手术类型、主动脉阻断时间），E/e′比值升高（≥ 8）与ICU LOS增加显著相关（49 vs 41中位小时，P = 0.037）和需要正性肌力支持（P = 0.002），而基线LVEF与单独正性肌力支持相关（P < 0.0001）。这些数据表明，组织多普勒衍生指数的左心室舒张充盈压可能是一个有用的指标，用于预测心脏手术后的早期病态事件，甚至可以提供额外的信息，从基线LVEF。此外，与E/e′ <8的患者相比，术前E/e′升高的患者可能需要更仔细的术中和术后管理。
The tissue Doppler-derived surrogate for left ventricular diastolic pressure, E/e′, has been used to prognosticate outcome in a variety of cardiovascular conditions. In this study we determined the relationship of intraoperative E/e′ to the use of inotropic support, duration of mechanical ventilation (MV), length of intensive care unit stay (ICU-LOS) and total hospital stay (H-LOS) in patients requiring cardiac surgery. The records of 245 consecutive patients were retrospectively reviewed to obtain 205 patients who had intraoperative transesophageal echocardiography (TEE) examinations prior to coronary artery bypass grafting (CABG) and/or valvular surgery. Cox proportional hazards and logistic regression models were used to analyze the relation between intraoperative E/e′ or LVEF and early postoperative morbidity (H-LOS, ICU-LOS, and MV) and the probability that a patient would require inotropic support. With adjustments for other predictors (female gender, hypertension, diabetes, history of myocardial infarction, emergency surgery, renal failure, procedure type, length of aortic cross-clamp time), an elevated E/e′ ratio (≥ 8) was significantly associated with an increased ICU-LOS (49 versus 41 median h, P = 0.037) and need for inotropic support (P = 0.002) while baseline LVEF associated with inotropic support alone (P < 0.0001). These data suggest that the tissue Doppler derived-index of left ventricular diastolic filling pressure may be a useful indicator for predicting early morbid events after cardiac surgery, and may even provide additional information from that of baseline LVEF. Further, patients with elevated preoperative E/e′ may need more careful peri- and postoperative management than those patients with E/e′ <8.
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影响因子：
2.8
作者：
De Sutter, J;De Backer, J;Gillebert, TC
通讯作者：
Gillebert, TC
DOI：
10.1046/j.1540-8175.2002.00467.x
发表时间：
2002-08-01
影响因子：
1.5
作者：
Chamoun, AJ;Xie, TR;Ahmad, M
通讯作者：
Ahmad, M
影响因子：
3.3
作者：
Hadano, Yasuyuki;Murata, Kazuya;Matsuzaki, Masunori
通讯作者：
Matsuzaki, Masunori
影响因子：
4.8
作者：
Bruch, C;Stypmann, J;Wichter, T
通讯作者：
Wichter, T
DOI：
10.1007/bf03022532
发表时间：
2006-10-01
期刊：
CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE
影响因子：
--
作者：
Denault, Andre Y.;Couture, Pierre;Tardif, Jean-Claude
通讯作者：
Tardif, Jean-Claude