Pre-Operative Reduced Atrial Compliance Is Predictive of Post-Operative Atrial Fibrillation in Patients Undergoing...

Area of Science:

• Cardiology
• Cardiac Surgery
• Medical Imaging

Background:

• Postoperative atrial fibrillation (POAF) is a common complication after esophagectomy.
• Predictors for POAF in esophagectomy patients are not well-established.
• This study investigates pre-operative bi-atrial strain as a potential POAF predictor.

Purpose of the Study:

• To determine if pre-operative bi-atrial strain analysis can predict POAF in patients undergoing esophagectomy.
• To assess the association between atrial strain parameters and POAF incidence.
• To identify novel echocardiographic markers for POAF risk stratification.

Main Methods:

• Fifty-nine patients undergoing esophagectomy with pre-operative echocardiography were included.
• Comprehensive myocardial strain analysis was performed, measuring left and right atrial (LA/RA) strain and global longitudinal strain (LV/RV GLS).
• Clinical variables and echocardiographic data were analyzed using multivariable models with POAF as the outcome.

Main Results:

• POAF incidence was 25.4%. Patients with POAF were older and had higher anastomotic leak rates.
• Reduced LA reservoir and conduit strain, and RA reservoir and conduit strain were observed in the POAF group (p < 0.05).
• Decreased LV GLS and RV GLS were also noted in patients with POAF (p < 0.05). Reduced LA reservoir strain independently predicted POAF (OR: 0.85, p < 0.001).

Conclusions:

• Reduced bi-atrial compliance, assessed by echocardiographic strain analysis, predicts POAF in esophagectomy patients.
• Subclinical global myocardial dysfunction may be present in surgical candidates.
• Comprehensive echocardiographic evaluation before esophageal surgery is recommended for risk stratification.