Preoperative Echocardiographic Indices of Diastolic Dysfunction and Brain Natriuretic Peptide in Predicting Postoperative Atrial Fibrillation After Noncardiac Surgery

Brecher, Oren; Gulati, Harleena; Roistacher, Nancy; Zhang, Hao; Shi, Wei; Thaler, Howard T.; Amar, David

doi:10.1213/ane.0000000000001471

Cited by 22 publications

(17 citation statements)

References 23 publications

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“…9,10,12 When we directly compared BNP level to echocardiography-derived parameters to predict POAF in a similar population of patients, indices of left atrial and diastolic dysfunction, but not BNP level, were independently associated with greater risk of POAF. 7 However, in that study, elevations in preoperative BNP level were correlated with older age and increased left atrial size and diastolic dysfunction among patients who mostly had no evidence of clinically significant cardiac dysfunction. 7 Traditionally, elevated atrial natriuretic peptide levels have been demonstrated in patients with heart failure and either ventricular or atrial wall distension.…”

Section: Discussionmentioning

confidence: 69%

“…7 However, in that study, elevations in preoperative BNP level were correlated with older age and increased left atrial size and diastolic dysfunction among patients who mostly had no evidence of clinically significant cardiac dysfunction. 7 Traditionally, elevated atrial natriuretic peptide levels have been demonstrated in patients with heart failure and either ventricular or atrial wall distension. BNP level may also increase with chronic conditions, such as aging, atrial fibrosis, and inflammation-factors that are also known to contribute to the occurrence of POAF in patients without clinical evidence of cardiac wall stretch or heart failure.…”

Section: Discussionmentioning

confidence: 69%

“…2,4 We and others have recently shown that preoperative echocardiographic indices of atrial enlargement and diastolic dysfunction are associated with risk of POAF after thoracic surgery. [5][6][7] Echocardiography, however, is not performed routinely before thoracic surgery, and, if it is performed, the special measurements needed to detect these factors require significant expertise and additional costs. By comparison, blood biomarkers are easy to analyze.…”

Section: Introductionmentioning

confidence: 99%

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A brain natriuretic peptide-based prediction model for atrial fibrillation after thoracic surgery: Development and internal validation

Amar

Zhang

Tan

et al. 2019

The Journal of Thoracic and Cardiovascular Surgery

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Objective-Postoperative atrial fibrillation (POAF) is common after anatomic thoracic surgery. Elevated preoperative brain natriuretic peptide (BNP) level is strongly associated with risk of POAF. We describe the development and internal validation of a clinical prediction model for POAF that includes BNP and other clinical factors. Methods-Clinical and preoperative BNP data were collected for 635 patients in sinus rhythm before anatomic lung (n=540) or esophageal (n=95) resection. The primary outcome was new onset of POAF (>5 min) during hospitalization. A prediction model was developed using multivariable logistic regression analysis and internally validated using a bootstrap-resampling approach. Results-POAF occurred in 20% of patients (124/635). BNP level was higher among patients with than without POAF (median, 45 vs 23 pg/mL; P<0.0001). The final prediction model included 5 factors: age (odds ratio [OR], 1.05 [95% CI, 1.02-1.08]; P=0.001), body mass index (OR, 1.05 [95% CI, 1.00-1.09]; P=0.016), BNP level (75 th vs. 25 th percentile, 57.5 vs 12.5 pg/mL; OR, 2.08 [95% CI, 1.26-3.43]; P=0.0003), history of atrial fibrillation (OR, 5.91 [95% CI, 2.47-14.11]; P<0.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 69%

Section: Introductionmentioning

confidence: 99%

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A brain natriuretic peptide-based prediction model for atrial fibrillation after thoracic surgery: Development and internal validation

Amar

Zhang

Tan

et al. 2019

The Journal of Thoracic and Cardiovascular Surgery

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“…A recent study performed in patients undergoing non-cardiac thoracic surgery demonstrated that increased LA volume index, reduced LA emptying fraction, and transmitral flow deceleration time were predictive of POAF. 38,39 Several prospective and retrospective studies have reported that a larger preoperative LA is associated with POAF after both cardiac valve surgery and CABG. [40][41][42][43][44][45][46][47] More advanced TTE measurements, such as speckletracking and strain analysis of the LA, have recently been investigated in numerous cardiac surgical populations.…”

Section: Imagingmentioning

confidence: 99%

<p>Predictors of Postoperative Atrial Fibrillation After Abdominal Surgery and Insights from Other Surgery Types</p>

Madsen¹,

Jørgensen²,

Leerhøy³

et al. 2020

RRCC

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Postoperative atrial fibrillation (POAF) in relation to abdominal surgery can cause clinical deterioration, prolonged hospitalization, admittance to intensive care units, stroke and increased mortality. The current review focus on patients developing POAF in relation to abdominal surgery and aims to present the current knowledge on predictors of this condition. Furthermore, predictors identified in other surgical populations that may be transferable and guide future research within the field of abdominal surgery will be presented. A systematic literature search of patients undergoing abdominal surgery and developing POAF was performed on PubMed and Embase. All types of study interventions, comparators and designs were included. All studies included reported POAF as primary or secondary outcome. All peer-reviewed English full-text manuscripts regardless of publication date were included. We included five studies out of the 149 unique records identified. Age, congestive heart failure, hypertension, vascular disease and surgical approach are risk factors associated with the development of POAF. Furthermore, inflammation biomarkers, dobutamine stress echocardiography and cardiac single-photon emission computed tomography can predict POAF. Insights from other surgical cohorts reveal that other biomarkers (ie, brain natriuretic peptide (BNP) and N-terminal pro-BNP), electrocardiography and echocardiography can be used to predict POAF and may be applied in future research projects within the field of abdominal surgery. In conclusion, very scarce evidence is currently available in predicting POAF after abdominal surgery. However, predicting POAF seems possible and feasible, why the authors encourage readers to initiate new research to close the current knowledge gap and improve clinical management.

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“…Однако понимание предсто-ящего объема оперативного вмешательства и достаточно Практическая медицина Problems of practical health care предоперационная ЭхоКГ не была связана с улучшением послеоперационных результатов [36]. Предоперационные уровни натрийуретических пептидов сильно коррелируют с прогнозом ХСН, послеоперационной смертностью и ос-ложненностью [37,38]. По сравнению с единичным опреде-лением пептидов, серийное улучшает риск-стратификацию по композитным точкам (смерть, нефатальный ИМ) [39].…”

Section: American College Of Surgeons (Acs) National Surgical Qualityunclassified

Evaluation of Cardiac-Vascular Complications Risk in Out-of-Cardiac Surgery: Comorbidity and Use of Clinical Evaluation Scale

Безденежных¹,

Sumin²

2017

SMR

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Оценка риска сердечно-сосудистых осложнений при внесердечных оперативных вмешательствах: коморбидность и применение шкал клинической оценки Evaluation of cardiac-vascular complications risk in out-of-cardiac surgery: comorbidity and use of clinical evaluation scale Безденежных А. В., Сумин А. Н. Bezdenezhnykh A. V., Sumin A. N. Dochkina Elena S., Profmed Ltd. Clinic Elife; Address: 115, Alekseeva Str., Krasnoyarsk 660135, Russian Federation, Phone: +7(391)2214010; e-mail: helenad.73@mail.ru Ustinova Alena V., Krasnoyarsk Regional Children`s Hospital; Address: 2A, Acad. Kirenskii Str., Krasnoyarsk 660051, Russian Federation; Phone: +7(391)2435673; e-mail: 2956959@mail.ru Taranushenko Tatyana E., Professor V. F. Voino-Yasenetsky Krasnoyarsk State Medical University; Address: 1, Partizan Zheleznyak Str., Krasnoyarsk 660022, Russian Federation; Phone: +7(391)2433952; e-mail: tetar@rambler.ru Поступила 17.07.2017 г. Принята к печати 13.09.2017 Сведения об авторах Дочкина Елена Семеновна, ООО «Профмед» Клиника Элайф; адрес: Россий-ская Федерация, 660135, г. Красноярск, ул. Алексеева, д. 115; тел.: +7(391)2214010; e-mail: helenad.73@mail.ru Устинова Алена Васильевна, Красноярская краевая детская больница; адрес: Российская Федерация, 660051, г. Красноярск, ул. Академика Киренского, д. 2А; тел.: +7(391)2435673; e-mail: 2956959@mail.ru Таранушенко Татьяна Евгеньевна, Красноярский государственный медицинский университет им. проф. В.Ф. Войно-Ясенецкого; адрес: Российская Федерация, 660022, г. Красноярск, ул. Партизана Железняка, д.1; тел.: +7(391) Резюме. Сердечно-сосудистые осложнения при внесердечных оперативных вмешательствах являются актуальной проблемой современ-ной медицины. Для управления риском таких осложнений создан ряд национальных и международных рекомендаций. В качестве ос-новы для принятия решения лечащим врачом в таких руководствах предлагаются алгоритмы, существенную часть которых составляет клиническая оценка периоперационного риска кардиальных осложнений. Для оптимизации работы врача или мультидисциплинарной команды специалистов предложен ряд шкал и индексов, позволяющий у постели больного оценить вероятность сердечно-сосудистых осложнений и помочь в принятии решения. В настоящей статье рассматриваются практические аспекты применения шкал клинической оценки риска, дается их сравнительная характеристика и особенности применения, а также обсуждаются практические подходы к управ-лению периоперационным кардиальным риском внесердечной хирургии при выявлении у пациента отдельных коморбидных состояний, оставшихся за пределами алгоритмов рекомендаций. Ключевые слова: некардиальные оперативные вмешательства, сердечно-сосудистые осложнения, клиническая оценка риска. Abstract. Cardiovascular complications with out-of-cardiac surgery are an urgent problem of modern medicine. A number of national and international recommendations have been established to manage the risk of such complications. As a basis for the decision of the physician in such guidelines algorithms are proposed, a significant part of ...

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Preoperative Echocardiographic Indices of Diastolic Dysfunction and Brain Natriuretic Peptide in Predicting Postoperative Atrial Fibrillation After Noncardiac Surgery

Cited by 22 publications

References 23 publications

A brain natriuretic peptide-based prediction model for atrial fibrillation after thoracic surgery: Development and internal validation

A brain natriuretic peptide-based prediction model for atrial fibrillation after thoracic surgery: Development and internal validation

<p>Predictors of Postoperative Atrial Fibrillation After Abdominal Surgery and Insights from Other Surgery Types</p>

Evaluation of Cardiac-Vascular Complications Risk in Out-of-Cardiac Surgery: Comorbidity and Use of Clinical Evaluation Scale

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