Echocardiographic prediction of postoperative atrial fibrillation after aortic valve replacement for aortic stenosis: A two-dimensional speckle tracking left ventricular longitudinal strain multicentre pilot study

Lévy, F.; Debry, Nicolas; Labescat, A.-L.; Meimoun, Patrick; Malaquin, Dorothée; Maréchaux, Sylvestre; Ruşinaru, Dan; Jeu, Antoine; Ennezat, Pierre‐Vladimir; Castel, Anne Laure; Tribouilloy, Christophe

doi:10.1016/j.acvd.2012.06.002

Cited by 39 publications

(31 citation statements)

References 24 publications

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“…The influence of enlarged left atrial on POAF has been demonstrated with CABG in several studies [20]. However, other previous reports [2, 11, 21], abandon the correlation of the size of left atrium and AF, assuming that dysfunctional left atrial is distinct of atrial remodeling. That may atributed to the younger age of their population in comparison to ours.…”

Section: Discussionmentioning

confidence: 99%

Factors influencing postoperative atrial fibrillation in patients undergoing on-pump coronary artery bypass grafting, single center experience

Ismail

Elmahrouk

Hamouda

et al. 2017

J Cardiothorac Surg

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BackgroundThe reported incidence of AF after CABG surgery varies from 20 to 40%, with the arrhythmia usually occurring between second and fourth postoperative days. Postoperative AF after CABG was associated with greater in-hospital mortality and worse survival at long-term follow-up. Therefore, intensive attention has focused on the prevention of AF in high-risk patients. Many perioperative factors have been suggested to increase the incidence of postoperative AF after conventional CABG. In this study we are trying to examine some of these risk factors as predictors for Post-operative AF in our patients. In this study, our aim was to identify the perioperative predictors of AF in our patients who underwent Coronary Artery Bypass Grafting.MethodsOur Patients were divided into two groups; Group A included patients who did not develop PO AF (168 patients) and Group B patients who developed PO AF (84 patients). Perioperative Data, including gender, age, demographic variables and postoperative morbidity and mortality were extracted from the medical records.ResultsThis retrospective cohort study was conducted on 252 consecutive adult patients underwent CABG, in King Faisal Specialist Hospital and Research Center in Jeddah, Saudi Arabia. The mean age for patients with PO AF was 65 years (P = .0001). Eight-three patients (49.4%) were diabetics in group A and 56 patients (66.7%) in group B (P = .0001). Patients who developed POAF had a lower ejection fraction (44.8 ± 5.7%) (P = .0001), diastolic dysfunction (P = .0001), Larger Left atrial volume (P = .0001). Bleeding requiring re-opening for exploration and Postoperative shock were identified as significant predictors for POAF. Multivariate logistic regression (odds ratio, ±95% CI, P value) was performed to identify the effect of age, preoperative heart rate, ejection fraction, postoperative bleeding, Shock, ventilator time, Sensitivity was 89.5%, specificity was 94.6%, positive predictive value was 89.5%, and negative predictive value was 94.6%.ConclusionIn our study, advanced age, enlarged LA volume, low ejection fraction, combined surgeries and prolonged ventilation time were found to be predictors of atrial fibrillations after coronary artery bypass grafting.

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Section: Discussionmentioning

confidence: 99%

Factors influencing postoperative atrial fibrillation in patients undergoing on-pump coronary artery bypass grafting, single center experience

Ismail

Elmahrouk

Hamouda

et al. 2017

J Cardiothorac Surg

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“…Prior work using volumetric methods has demonstrated that the contractile phase of LA function is impaired following mitral valve repair, suggesting that pre-operative atrial dysfunction is masked by the presence of MR 33,34 . More recently, speckle-tracking techniques have been used to examine atrial function, and has subsequently proved useful in a number of clinical scenarios, including predicting the development of atrial fibrillation during cardiac surgery or in the presence of mitral valve disease 22,35,36 . Alterations in LA strain may reflect histopathological changes occurring within the atrium: in a group of patients who underwent LA biopsy at the time of surgery for MVP, the extent of fibrosis corresponded to reductions in atrial function derived using speckle-tracking imaging 37 .…”

Section: Discussionmentioning

confidence: 99%

Left Atrial Function Is Associated with Earlier Need for Cardiac Surgery in Moderate to Severe Mitral Regurgitation: Usefulness in Targeting for Early Surgery

Ring

Abu‐Omar

Kaye

et al. 2018

Journal of the American Society of Echocardiography

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“…In asymptomatic moderate and severe AS patients with preserved LVEF, reduced GLS worse than -15% was a significant risk factor for cardiac hospitalization, AVR, cardiovascular death[30,31], all-cause mortality at one year[24], and, interestingly, increased risk of post-operative atrial fibrillation independent of left atrial size and age[32]. Other studies have established that regional deformation analysis is also important, with an additional parameter called basal longitudinal strain (BLS) less than -13% associated with adverse outcomes including heart failure, MI, all-cause mortality, and symptomatic status in asymptomatic severe AS.…”

Section: Aortic Stenosismentioning

confidence: 99%

Newer echocardiographic techniques for aortic-valve imaging: Clinical aids today, clinical practice tomorrow

Tiwari

Patel

2017

WJC

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Increasing life expectancy is expected to lead to a corresponding increase in the prevalence of aortic valve disease (AVD). Further, the number of indications for transcatheter aortic valve replacement (TAVR) as a treatment option for AVD is expanding, with a growing role for echocardiography in its management. In this review we summarize the current literature on some newer echocardiographic modalities and the parameters they generate, with a particular focus on their prognostic and clinical value beyond conventional methods in the management of aortic stenosis, TAVR, and aortic regurgitation. Speckle tracking and 3D echocardiography are now increasingly being used in the management of AVD. For instance, global longitudinal strain, the best-studied speckle tracking echocardiographic parameter, can detect subtle subclinical cardiac dysfunction in patients with AVD that is not apparent using traditional echocardiographic techniques. The emerging technique of 3D full volume color Doppler echocardiography provides more accurate measurement of the severity of aortic regurgitation than 2D-proximal isovelocity surface area. These novel techniques are promising for evaluating and risk stratifying patients to optimize surgical interventions, predict recovery, and improve clinical outcomes.

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Echocardiographic prediction of postoperative atrial fibrillation after aortic valve replacement for aortic stenosis: A two-dimensional speckle tracking left ventricular longitudinal strain multicentre pilot study

Abstract: Incidence of POAF is high after AVR for severe aortic stenosis. Our results suggest an additive value of the study of left ventricular myocardial deformation to classical clinical and echocardiographic variables for the prediction of POAF in this setting.

Cited by 39 publications

References 24 publications

Factors influencing postoperative atrial fibrillation in patients undergoing on-pump coronary artery bypass grafting, single center experience

Factors influencing postoperative atrial fibrillation in patients undergoing on-pump coronary artery bypass grafting, single center experience

Left Atrial Function Is Associated with Earlier Need for Cardiac Surgery in Moderate to Severe Mitral Regurgitation: Usefulness in Targeting for Early Surgery

Newer echocardiographic techniques for aortic-valve imaging: Clinical aids today, clinical practice tomorrow

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