Clinical and echocardiographic predicators of postoperative atrial fibrillation

Elawady, Moataz; Bashandy, Mohamed A.

doi:10.1177/0218492313503572

Cited by 6 publications

(7 citation statements)

References 23 publications

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“…AEI duration among 115-147 ms is related to adequate prediction of POAF after coronary artery bypass graft surgery. 4,6,17,20 In the analyzed population, AEI was significantly lower, probably due to the exclusion of patients with preoperative beta-blocker therapy (with a recognized prophylactic effect on POAF) in our sample. 4,6,17,20 Postoperative echocardiographic controls showed an early reduction of LAVI and LAD after valve surgery.…”

Section: Discussionmentioning

confidence: 86%

“…4,6,17,20 In the analyzed population, AEI was significantly lower, probably due to the exclusion of patients with preoperative beta-blocker therapy (with a recognized prophylactic effect on POAF) in our sample. 4,6,17,20 Postoperative echocardiographic controls showed an early reduction of LAVI and LAD after valve surgery. 21,22 Early atrial reverse remodeling was also appreciated in our sample, but only among No-POAF patients.…”

Section: Discussionmentioning

confidence: 86%

“…6,8 Increasing in E and A-waves velocity, E/A ratio and LAD, positively correlated with higher incidence of AF, both among general population and after cardiac surgery. [4][5][6]17,18 However, our results suggest that valve disease and age-related changes in atrial function could modify these preoperative values [8][9][10]19 invalidating their effectiveness as predictors of POAF.…”

Section: Discussionmentioning

confidence: 99%

“…Longer A-wave and atrial electromechanical interval (AEI), increased E/A ratio, and higher diameter and indexed left atrial volume were more prevalent in patients suffering from POAF. [4][5][6] Patients with preoperative abnormal right ventricular performance index were more likely to present POAF after GABG. 7 Anyway, their predictive value has not been adequately validated after heart valve procedures.…”

Section: Introductionmentioning

confidence: 98%

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Echocardiography Parameters Predicting Postoperative Atrial Fibrillation: their Influence on Early left Atrial Remodelling and Right Ventricular Function after Heart Valve Surgery

Carrascal¹

2019

JCCI

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Objective: To identify relationship between echocardiographic parameters variations and risk of postoperative atrial fibrillation (POAF) after cardiac valve surgery. Design: Prospective. Case-control study. Setting: A university hospital. Participants:We analysed the incidence of POAF in 90 patients undergoing elective heart valve surgery. POAF was considered when episodes equal or longer than 5 minutes, and those under 5 minutes with hemodynamic disturbances. Interventions: None.Measurements and main results: POAF incidence was 36.7%. Preoperative echocardiographic study showed higher systolic pulmonary pressure (p: 0.047) and longer atrial electromechanical interval (AEI) (0.049) in POAF group. Postoperative echocardiographic evaluation revealed higher TAPSE decreasing related with preoperative values (8.18± 4.33 mm in No-POAF vs. 10.35 ± 3.83 mm in POAF group) (p: 0.026). In multivariate logistic regression POAF correlated with age> 65 years (p: 0.007) OR: 4.80; IC 95% (1.52-15.14), longer preoperative AEI (p: 0.042) OR: 1.029 IC 95% (1.001-1.059), higher TAPSE reduction (p: 0.040) OR: 1.15 IC 95% (1.006-1.316) and postoperative left atrial volume index> 36 ml / m2 (p = 0.0203) OR: 3.63; 95% . Conclusions: After heart valve surgery, POAF favoured right ventricular dysfunction (evidenced by higher postoperative TAPSE decreasing) and impaired early left atrial remodelling. In older patients and those with preoperative longer AEI, biatrial pacing and pharmacological prophylaxis might prevent these undesirable POAF effects.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

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Echocardiography Parameters Predicting Postoperative Atrial Fibrillation: their Influence on Early left Atrial Remodelling and Right Ventricular Function after Heart Valve Surgery

Carrascal¹

2019

JCCI

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“…В нашем исследовании увеличенный диаметр ЛП ассоциировался с риском возникновения ПОФП, что подтверждается результатами литературы [9,10]. ПОФП имеет два основных патофизиологических механизма, которые могут быть связаны с размерами ЛП: дегенеративные изменения миокарда предсердий и предоперационные электрофизиологические изменения.…”

Section: Discussionunclassified

Clinical, echocardiographic parameters and markers of oxidative stress associated with atrial fibrillation in patients undergoing coronary artery bypass graft surgery

Рубаненко¹,

Рубаненко²,

Щукин³

et al. 2020

Russ J Cardiol

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Цель. Оценить взаимосвязь клинических, эхокардиографических показателей и маркеров окислительного стресса с развитием послеоперационной фибрилляции предсердий (ПОФП) у пациентов с ишемической болезнью сердца (ИБС), подвергающихся коронарному шунтированию (КШ). Материал и методы. В рамках исследования "случай-контроль" обследовано 158 пациентов с ИБС, поступивших для проведения КШ. Пациенты разделены на две группы: 1-я группа-без ПОФП (111 больных, 82,0% мужчин, медиана возраста 62,0 [56,0;66,0] года), 2-я группа с ПОФП (47 больных, 84,4% мужчин, медиана возраста 65,0 [61,0;70,0] лет). Медиана развития ПОФП составила 5,2 [2,0;7,0] сут. после КШ. Проводилось исследование содержания супероксиддисмутазы в плазме и в эритроцитах, миелопероксидазы в плазме, каталазы, малонового диальдегида, восстановленного глутатиона (ВГ), глутатионредуктазы (ГР), глутатионпероксидазы (ГПО) в эритроцитах, оксида азота (NO) в плазме, продукты окисления белков. Исследование показателей осуществлялось в предоперационном периоде и в среднем на 3-4 сут. после КШ. Всем пациентам также проводилась эхокардиография. Результаты. После выполнения многофакторного регрессионного анализа отношение шансов развития ПОФП выявлено для следующих показателей: диаметра левого предсердия >41 мм-4,1 (95% доверительный интервал (ДИ),

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Scores predicting atrial fibrillation after mitral valve surgery: Do we need a more specific score?

Albabtain,

Almathami,

Alghosoon

et al. 2024

Journal of Arrhythmia

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BackgroundAtrial fibrillation after cardiac surgery (POAF) is associated with increased morbidity and mortality. Several scores were used to predict POAF, with variable results. Thus, this study assessed the performance of several scoring systems to predict POAF after mitral valve surgery. Additionally, we identified the risk factors for POAF in those patients.MethodsThis retrospective cohort included 1381 recruited from 2009 to 2021. The patients underwent mitral valve surgery, and POAF occurred in 233 (16.87%) patients. The performance of CHADS2, CHA2DS2‐VASc, POAF, EuroSCORE II, and HATCH scores was evaluated.ResultsThe median age was higher in patients who developed POAF (60 vs. 54 years; p < .001). CHA2‐DS2‐VASc, POAF, EuroSCORE II, and HATCH scores significantly predicted POAF, with areas under the curve of the receiver operator curve (AUCROC) of 0.56, 0.61, 0.58, and 0.54, respectively. We identified age > 58 years, body mass index > 28 kg/m2, creatinine clearance < 90 mL/min, reoperative surgery, and preoperative inotropic and intra‐aortic balloon pump use as predictors of POAF. We constructed a score from these variables (PSCC‐AF). A score > 2 significantly predicted POAF (p < .001). The AUCROC of this score was 0.67, which was significantly higher than the AUCROC of the POAF score (p = .009).ConclusionPOAF after mitral valve surgery can be predicted based on preoperative patient characteristics. The new PSCC‐AF score significantly predicted POAF after mitral valve surgery and can serve as a bedside diagnostic tool for POAF risk screening. Further studies are needed to validate the PSCC‐AF‐mitral score externally.

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Clinical and echocardiographic predicators of postoperative atrial fibrillation

Abstract: Older hypertensive patients are at higher risk of developing postoperative atrial fibrillation. Preoperative measurement of atrial electromechanical interval by tissue Doppler echocardiography is a useful predictor of postoperative atrial fibrillation in coronary artery bypass patients.

Cited by 6 publications

References 23 publications

Echocardiography Parameters Predicting Postoperative Atrial Fibrillation: their Influence on Early left Atrial Remodelling and Right Ventricular Function after Heart Valve Surgery

Echocardiography Parameters Predicting Postoperative Atrial Fibrillation: their Influence on Early left Atrial Remodelling and Right Ventricular Function after Heart Valve Surgery

Clinical, echocardiographic parameters and markers of oxidative stress associated with atrial fibrillation in patients undergoing coronary artery bypass graft surgery

Scores predicting atrial fibrillation after mitral valve surgery: Do we need a more specific score?

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