open access

Vol 72, No 6 (2014)
Original articles
Published online: 2013-12-17
Get Citation

The effect of mild left ventricular diastolic dysfunction on outcome after isolated coronary bypass surgery

Aleks Değirmencioğlu, Şahin Şenay, Ümit Güllü, Ertuğrul Zencirci, Gültekin Karakuş, Murat Ugur, Ali Buturak, Cem Alhan
DOI: 10.5603/KP.a2013.0354
·
Kardiol Pol 2014;72(6):541-545.

open access

Vol 72, No 6 (2014)
Original articles
Published online: 2013-12-17

Abstract

Background: Although moderate to severe diastolic dysfunction (DD) seems to be associated with poor prognosis after isolated coronary bypass surgery, the impact of mild DD has not been investigated extensively in this group of patients.

Aim: We evaluated the prognostic implication of mild left ventricular (LV) DD on outcome after isolated coronary bypass surgery in patients with preserved LV systolic function.

Methods: Data from 650 patients undergoing isolated coronary bypass surgery and having records for LV diastolic function between January 2009 and August 2011 was collected retrospectively. DD was classified as mild (grade 1, impaired relaxation), moderate (grade 2, decreased compliance) or 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 LV 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 tothe echocardiographic findings as follows: group 1 comprised patients with normal diastolic function (n = 168); and group 2 was made up of patients with mild DD (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 compared to group 2 in terms of need for inotropic support (20.2% vs. 16.2%), intra-aortic balloon pump usage (0% vs. 1.4%), mechanical ventilation time (8.94 ± 0.96 h vs. 10.0 ± 0.89 h), reintubation rate (1.8% vs. 1.4%), intensive care unit stay time (24.1 ± 1.4 hvs. 26.2 ± 1.9 h), postoperative renal failure rate (0% vs. 0.3%), postoperative atrial fibrillation rate (10.1% vs. 11.2%), length of hospital stay (7.19 ± 0.45 vs. 6.57 ± 0.14 days), hospital readmission rate (3.1% vs. 3.1%), and mortality (0% vs. 1.6%).

Conclusions: The results from this study indicate that mild LV DD is not associated with adverse outcome after coronary bypass surgery in patients with preserved LV systolic function, thus should not be considered as a preoperative risk factor.

Abstract

Background: Although moderate to severe diastolic dysfunction (DD) seems to be associated with poor prognosis after isolated coronary bypass surgery, the impact of mild DD has not been investigated extensively in this group of patients.

Aim: We evaluated the prognostic implication of mild left ventricular (LV) DD on outcome after isolated coronary bypass surgery in patients with preserved LV systolic function.

Methods: Data from 650 patients undergoing isolated coronary bypass surgery and having records for LV diastolic function between January 2009 and August 2011 was collected retrospectively. DD was classified as mild (grade 1, impaired relaxation), moderate (grade 2, decreased compliance) or 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 LV 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 tothe echocardiographic findings as follows: group 1 comprised patients with normal diastolic function (n = 168); and group 2 was made up of patients with mild DD (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 compared to group 2 in terms of need for inotropic support (20.2% vs. 16.2%), intra-aortic balloon pump usage (0% vs. 1.4%), mechanical ventilation time (8.94 ± 0.96 h vs. 10.0 ± 0.89 h), reintubation rate (1.8% vs. 1.4%), intensive care unit stay time (24.1 ± 1.4 hvs. 26.2 ± 1.9 h), postoperative renal failure rate (0% vs. 0.3%), postoperative atrial fibrillation rate (10.1% vs. 11.2%), length of hospital stay (7.19 ± 0.45 vs. 6.57 ± 0.14 days), hospital readmission rate (3.1% vs. 3.1%), and mortality (0% vs. 1.6%).

Conclusions: The results from this study indicate that mild LV DD is not associated with adverse outcome after coronary bypass surgery in patients with preserved LV systolic function, thus should not be considered as a preoperative risk factor.

Get Citation

Keywords

coronary bypass, diastolic dysfunction, outcome

About this article
Title

The effect of mild left ventricular diastolic dysfunction on outcome after isolated coronary bypass surgery

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 72, No 6 (2014)

Pages

541-545

Published online

2013-12-17

DOI

10.5603/KP.a2013.0354

Bibliographic record

Kardiol Pol 2014;72(6):541-545.

Keywords

coronary bypass
diastolic dysfunction
outcome

Authors

Aleks Değirmencioğlu
Şahin Şenay
Ümit Güllü
Ertuğrul Zencirci
Gültekin Karakuş
Murat Ugur
Ali Buturak
Cem Alhan

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Sp. z o.o. VM Group Sp.k., ul. Świętokrzyska 73 , 80–180 Gdańsk, Poland

phone:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl