Coronary Artery Bypass Grafting in Patients with Severe Left Ventricular Dysfunction: Predictive Significance of Left Ventricular Diastolic Filling Pattern

Vaškelytė, Jolanta Justina; Stoškutė, Neris; Kinduris, Šarūnas; Ereminienė, Eglė

doi:10.1053/euje.2000.0051

Cited by 33 publications

(9 citation statements)

References 17 publications

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“…The clinical impact of preoperative left ventricular (LV) [1][2][3][4][5] and right ventricular (RV) 4,6 diastolic dysfunction on perioperative morbidity and mortality is increasingly recognized. The presence of severe LV diastolic dysfunction is associated with hemodynamic instability after cardiopulmonary bypass (CPB) and has been correlated with postoperative cardiac events 1 yr after coronary artery bypass graft (CABG) surgery.…”

Section: Résumémentioning

confidence: 99%

Effects of anesthetic induction in patients with diastolic dysfunction

Couture

Denault

Shi

et al. 2009

Can J Anesth/J Can Anesth

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In patients with left ventricular diastolic dysfunction, cardiac dimensions and bi-ventricular filling patterns are significantly altered after induction of general anesthesia. These changes can be explained to some extent by a reduction in venous return with general anesthesia, reduced atrial contractility, and the effect of positive pressure ventilation. Although the LV diastolic function score improved after induction of anesthesia, it is difficult to dissociate this effect from that of altered loading conditions.

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Section: Résumémentioning

confidence: 99%

Effects of anesthetic induction in patients with diastolic dysfunction

Couture

Denault

Shi

et al. 2009

Can J Anesth/J Can Anesth

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“…This problem is illustrated by existing studies. Vaskelyte et al [29], using our original definition for restrictive filling, reported that in patients with LVEF ≤ 35% a restrictive pattern (E/A ≥ 2 or an E/A ratio between 1 and 2 with a deceleration time b 150 ms) correlated with high early postoperative mortality, morbidity and minimal improvement in LV systolic function. Several other authors, including as previously mentioned Poulsen et al, have defined restrictive LV filling as a deceleration time b 140 ms independent of age [11].…”

Section: Covariatementioning

confidence: 99%

Diastolic dysfunction and autonomic abnormalities in patients with systolic heart failure

Stein

Tereshchenko

Domitrovich

et al. 2007

European J of Heart Fail

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Background: Patients with systolic heart failure (SHF) often have concomitant diastolic dysfunction (DD). SHF is associated with decreased heart rate variability (HRV), but the impact of degree of DD on HRV in SHF is unclear. Methods and results: HRV was measured in 139 patients, aged 64 ± 12 years, 74% male, LVEF 30 ± 8%. Patients had stable NYHA class II-III CHF on ACE inhibitors or ATII receptor blockers, with LVEF ≤ 40% and BNP ≥ 200 pg/ml. Subjects underwent 2-D echocardiography with Doppler assessment and 24-h Holters. Patients were categorized as having impaired relaxation (E-deceleration time N 2 SD above ageadjusted normal values (AANV), E/A ≤ 1, systolic/diastolic pulmonary vein flow ≥ 1; N = 30), pseudonormal (E-deceleration time within 2 SD of AANV, E/A = 1-2, systolic/diastolic pulmonary vein flow b 1; N = 25) or restrictive filling patterns (E-deceleration time N 2 SD below AANV or/and E/A ratio ≥ 2; N = 84) Differences were adjusted for clinical covariates using UNIANOVA, p b 0.05. HRV was reduced and BNP higher in pseudonormal patients compared to impaired relaxation, but this difference was only significant for restrictive vs. impaired filling. Differences remained significant after adjustment for covariates. Conclusion: Significantly more abnormal HRV, reflecting greater cardiac autonomic dysfunction, is associated with restrictive DD compared to impaired relaxation.

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“…Prognostic value of the LV diastolic filling pattern has been already demonstrated in patients with CAD, undergoing CABG. 25 Our previous study revealed that restrictive LV diastolic filling is the marker of poor prognosis in patients with low LV EF undergoing CABG, as the postoperative complication rate (55.5%) and the perioperative mortality rate (33%) were highest in the restriction group. Furthermore, LV diastolic dysfunction was proved to be more sensitive than LV sys-tolic dysfunction (decreased LV EF) in predicting cardiac events after CABG.…”

Section: Discussionmentioning

confidence: 87%