[A. N. Bakoulev Scientific Center for Cardiovascular Surgery]

Area of Science:

• Cardiology
• Cardiac Surgery
• Diagnostic Imaging

Background:

• Diastolic dysfunction (DD) is a critical concern in patients with acquired heart diseases, particularly after surgical correction.
• Understanding the dynamics of diastolic function post-surgery is crucial for predicting outcomes and identifying underlying causes.

Purpose of the Study:

• To assess the progression of diastolic function and identify the development and causes of diastolic dysfunction (DD) post-surgery.
• To evaluate the impact of DD on postoperative prognosis in patients undergoing acquired heart defect correction.

Main Methods:

• 112 patients with aortic and mitral valve diseases underwent serial echocardiography (echo), tissue Doppler, and speckle tracking echo.
• Dynamic contrast-enhanced magnetic resonance imaging was performed in a subset of patients.
• Patients were stratified based on postoperative heart failure (HF) and left ventricular ejection fraction (EF) status.

Main Results:

• Initially normal diastolic function was observed in 30.4% of patients, with DD emerging in 26.5% postoperatively.
• The development of left ventricular (LV) DD correlated with decreased septal velocity, particularly in patients with fibrosis.
• A prognostic model incorporating global left atrial longitudinal strain and E/e ratio on tricuspid lateral annular velocity was developed.

Conclusions:

• Postoperative DD after acquired heart defect correction is linked to septal diastolic function damage, often associated with fibrosis and inadequate myocardial protection.
• A predictive model for heart failure with preserved ejection fraction (HFpEF) post-operation was established.