Diastolic function and new-onset atrial fibrillation following cardiac surgery

David Barbara, Kent Rehfeldt, Juan Pulido, Zhuo Li, Roger White, Hartzell V Schaff, William Mauermann

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)8-14
Number of pages7
JournalAnnals of Cardiac Anaesthesia
Volume18
Issue number1
DOIs
StatePublished - Jan 1 2015

Fingerprint

Atrial Fibrillation
Thoracic Surgery
Pulmonary Artery
Mitral Valve
Pressure
Hypertrophic Cardiomyopathy
Population Characteristics
Length of Stay
Demography
Prospective Studies
Blood Pressure
Hypertension
Morbidity
Costs and Cost Analysis
Mortality

Keywords

  • Atrial fibrillation
  • Cardiac surgery
  • Diastolic dysfunction
  • Diastolic function
  • Postoperative

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Diastolic function and new-onset atrial fibrillation following cardiac surgery. / Barbara, David; Rehfeldt, Kent; Pulido, Juan; Li, Zhuo; White, Roger; Schaff, Hartzell V; Mauermann, William.

In: Annals of Cardiac Anaesthesia, Vol. 18, No. 1, 01.01.2015, p. 8-14.

Research output: Contribution to journalArticle

Barbara, David ; Rehfeldt, Kent ; Pulido, Juan ; Li, Zhuo ; White, Roger ; Schaff, Hartzell V ; Mauermann, William. / Diastolic function and new-onset atrial fibrillation following cardiac surgery. In: Annals of Cardiac Anaesthesia. 2015 ; Vol. 18, No. 1. pp. 8-14.
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N2 - 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.

AB - 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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