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Preexisting Right Ventricular Diastolic Dysfunction and Postoperative Cardiac Complications in Patients Undergoing

Alexey N Sumin1, Ekaterina V Korok1, Tatjana Ju Sergeeva1

  • 1Federal State Budgetary Institution "Research Institute for Complex Issues of Cardiovascular Disease", Kemerovo, Russia.

Journal of Cardiothoracic and Vascular Anesthesia
|October 11, 2020
PubMed

Insights

Preoperative right ventricular diastolic dysfunction (RVDD) significantly increases the risk of postoperative heart failure after coronary artery bypass grafting (CABG). Echocardiography can identify patients at higher risk, guiding preventative strategies.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Echocardiography

Background:

  • Right ventricular diastolic dysfunction (RVDD) is a potential complication in patients undergoing coronary artery bypass grafting (CABG).
  • The association between preoperative RVDD and postoperative cardiac complications after CABG requires further investigation.

Purpose of the Study:

  • To determine if preexisting RVDD in patients undergoing CABG is linked to a higher incidence of postoperative cardiac complications.
  • To identify echocardiographic markers that predict postoperative heart failure (PHF) after CABG.

Main Methods:

  • A retrospective cohort study involving 200 patients undergoing CABG.
  • Transthoracic echocardiography was used to assess right ventricular (RV) diastolic function parameters.
  • Patients were categorized into groups with and without RVDD.

Main Results:

  • Patients with RVDD had a significantly higher incidence of postoperative heart failure (PHF) compared to controls (p=0.026).
  • Independent predictors of PHF included RVDD (OR 4.82), cardiopulmonary bypass (OR 4.04), and female sex.
  • A decreased Et/At ratio was identified as the best echocardiographic predictor of PHF.

Conclusions:

  • Preoperative RVDD, cardiopulmonary bypass, and female sex are independent risk factors for PHF post-CABG.
  • Echocardiographic assessment of RV diastolic function, particularly the Et/At ratio, can aid in predicting PHF.
  • Further studies are needed to confirm the utility of preoperative RV diastolic function assessment for predicting PHF after CABG.
Abstract

Keywords:
coronary artery bypass surgerydiastolic dysfunctionpostoperative cardiac complicationsright ventricular

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