Left and right ventricular diastolic dysfunction as predictors of difficult separation from cardiopulmonary bypass

Abstract

Moderate and severe LVDD and RVDD can be identified with very good reproducibility, and both degrees of diastolic dysfunction are associated with DSB.

Milrinone enhances systolic, but not diastolic function during coronary artery bypass grafting surgery

“…P REOPERATIVE left ventricular (LV) diastolic dysfunction appears to be a stronger predictor of hemodynamic instability after cardiopulmonary bypass (CPB) compared to systolic dysfunction 1 and more severe diastolic dysfunction present before cardiac surgery is associated with difficult separation from CPB. 2 Moreover, the presence of LV diastolic dysfunction has been shown to be an independent predictor of cardiac events (cardiac death, repeat hospital admission for congestive heart failure or myocardial infarction, and angina pectoris) at one year after coronary artery bypass graft (CABG) surgery. 3 This is clinically important because the prevalence of diastolic dysfunction in elderly and hypertensive patients undergoing cardiac surgery has been estimated to be 30%.…”

“…We have previously observed that both left and right ventricular diastolic abnormalities were the most common echocardiographic findings in hemodynamically unstable patients after cardiac surgery, 4 and preoperative right ventricular diastolic dysfunction was associated with increased need for vasoactive drug support after surgery. 2,5 Because preoperative left and right ventricular diastolic dysfunction are associated with post-CPB hemodynamic instability, improvement of LV diastolic function could represent an approach to reduce the risk of instability following cardiac surgery.…”

“…In this view, the tricuspid annulus is parallel to the Doppler axis. 2,18 Mitral flow propagation velocity (Vp) was also studied with the colour M-mode spectrum. To measure Vp, a four-chamber view was obtained, and the M-mode plane was extended from the apex to the tips of the mitral valve leaflets.…”

“…Our inter-observer variability for the assessment of systolic and diastolic function has been published previously. 1,2,4,20,21 The use of the LV diastolic dysfunction and right ventricular diastolic dysfunction criteria were previously validated 2 using Cohen's kappa values. 22 The kappa values were 0.77 and 0.82 for inter-observer agreement for the left and right ventricular evaluations respectively.…”

Left Ventricgle Diastolic Function in Patients After Coronary Bypass Surgery

“…По-прежнему остаются раз-ночтения в эффективности восстановления крово-тока после выполнения операций с ИК и на рабо-тающем сердце. По литературным данным, средняя и тяжелая степени диастолической дисфункции ЛЖ связаны с тяжелым состоянием пациентов при отключении аппарата искусственного кровооб-ращения, требующем подключения инотропных препаратов [50]. Несомненно, важным является установление причин, ухудшающих результат опе раций реваскуляризации миокарда.…”