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Clinical impact of diastolic function after surgical ventricular restoration

Takeshi Shimamoto1, Genichi Sakaguchi2, Tatsuhiko Komiya2

  • 1Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki, Japan ts12295@kchnet.or.jp.

Asian Cardiovascular & Thoracic Annals
|May 29, 2014
PubMed

Insights

Surgical ventricular restoration improves systolic function but can worsen diastolic function. Postoperative diastolic dysfunction is linked to increased mortality and cardiac events after this procedure.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Echocardiography

Background:

  • The clinical impact of diastolic function on outcomes following surgical ventricular restoration (SVR) is not well-established.
  • SVR aims to improve left ventricular function in patients with heart failure.

Purpose of the Study:

  • To investigate the effect of SVR on diastolic function.
  • To identify risk factors for mortality and cardiac events after SVR.
  • To assess the correlation between diastolic function and clinical outcomes.

Main Methods:

  • Retrospective analysis of 71 patients undergoing SVR between 1999 and 2012.
  • Comparison of perioperative echocardiographic parameters, focusing on systolic and diastolic function.
  • Multivariate analysis to identify risk factors for death and cardiac events.
  • Calculation of actuarial freedom from death and cardiac events.

Main Results:

  • SVR significantly improved left ventricular systolic function (ejection fraction increased, end-systolic volume index decreased).
  • Postoperative diastolic function showed deterioration, indicated by a decreased transmitral filling deceleration time and increased early peak filling velocity ratio.
  • Freedom from death and cardiac events at 5 years was 78% and 64%, respectively.
  • Age, postoperative transmitral inflow pattern, and preoperative mitral regurgitation were significant risk factors for mortality and cardiac events.

Conclusions:

  • SVR positively impacts systolic function but adversely affects postoperative diastolic function.
  • Severe postoperative diastolic dysfunction may be associated with increased late mortality and cardiac events.
  • Diastolic function assessment is crucial for predicting outcomes after SVR.
Abstract

Keywords:
Cardiac surgical procedurescardiomyopathydiastoledilatedheart ventricleslefttreatment outcomeventricular dysfunction

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