The Outcomes of Coronary Artery Bypass Surgery after 18 Months—Is There an Influence of the Initial Right Ventricle Diastolic Dysfunction?
Abstract
:1. Introduction
2. Subjects, Materials and Methods
2.1. Study Population
2.2. Data Collection
2.3. Echocardiographic Examination
2.4. Follow Up
2.5. Statistical Analyses
3. Results
AMI—Acute Myocardial Infarction
4. Discussion
Study Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | Group 1 without MACE (n = 170) | Group 2 MACE (n = 19) | p |
---|---|---|---|
Clinical and anamnestic data | |||
Male, n (%) | 127 (74.71) | 18 (94.74) | 0.05 |
Age, ME (LQ, UQ) (y) | 64.0 (60.0;68.0) | 64.0 (62.0;67.0) | 0.613 |
Body mass index, ME (LQ, UQ) (kg/m2) | 28.7 (25.7;30.5) | 29.4 (27.3;33.3) | 0.129 |
Smoking, n (%) | 50 (30.12) | 7 (36.84) | 0.547 |
Hypertension, n (%) | 18 (94.74) | 161 (94.71) | 0.995 |
Angina pectoris, n (%) | 147 (86.47) | 18 (94.74) | 0.304 |
Myocardial infarction history, n (%) | 105 (61.76) | 16 (84.21) | 0.053 |
Rhythm disturbances, n (%) | 31 (18.34) | 4 (21.05) | 0.773 |
Diabetes mellitus, n (%) | 43 (25.29) | 7 (36.84) | 0.279 |
Stroke history, n (%) | 15 (8.82) | 2 (10.53) | 0.805 |
PCI history, n (%) | 32 (18.82) | 2 (10.53) | 0.371 |
CHF NYHA III FC, n (%) | 31 (18.24) | 8 (42.11) | 0.014 |
Carotid atherosclerosis >50%, n (%) | 33 (19.41) | 3 (15.76) | 0.702 |
Hyperlipidemia, n (%) | 113 (66.47) | 10 (52.63) | 0.231 |
Therapy before surgery | |||
Betablocker, n (%) | 157 (62.35) | 17 (89.47) | 0.659 |
Statins, n (%) | 163 (95.88) | 18 (94.74) | 0.814 |
Calcium-channel blockers, n (%) | 122 (71.76) | 16 (84.21) | 0.246 |
ACE-I, n (%) | 130 (76.47) | 15 (78.95) | 0.808 |
Aspirin, n (%) | 158 (92.94) | 17 (89.47) | 0.584 |
Surgical procedure | |||
Ventriculoplasty, n (%) | 14 (8.24) | 2 (10.53) | 0.733 |
Thrombectomy, n (%) | 8 (4.71) | 1 (5.26) | 0.913 |
Radiofrequency ablation, n (%) | 5 (2.94) | 0 | 0.448 |
Carotid endarterectomy, n (%) | 18 (10.59) | 3 (15.79) | 0.493 |
Bypass graft number, ME (LQ, UQ) | 3.0 (2.0;3.0) | 3.0 (2.0;3.0) | 0.089 |
Cardiopulmonary bypass duration, ME (LQ; UQ) (min) | 76.0 (65.0;92.0) | 89.5 (74.0;99.0) | 0.053 |
Aortic cross-clamp time, ME (LQ; UQ) (min) | 50.0 (40.0;61.0) | 59.5 (51.0;64.0) | 0.092 |
Characteristics | Group 1 without MACE (n = 170) | Group 2 MACE (n = 19) | p |
---|---|---|---|
Structural indicators and systolic function | |||
Aorta, mm ME (LQ, UQ) | 3.5 (3.3;3.8) | 3.5 (3.4;3.8) | 0.547 |
LA, ME (LQ; UQ)mm | 4.4 (4.1;4.8) | 4.6 (4.3;5.0) | 0.168 |
EDD, ME (LQ; UQ) mm | 5.5 (5.2;6.1) | 6.0 (5.5;6.2) | 0.027 |
EDDi, ME (LQ; UQ) mm/m2 | 2.91 (2.76;3.16) | 2.95 (2.76;3.01) | 0.94 |
ESD, ME (LQ;UQ) mm | 3.6 (3.3;4.0) | 4.1 (3.8;4.3) | 0.005 |
ESDi, ME (LQ; UQ) mm/m2 | 1.87(1.71;2.11) | 2.02(1.89;2.2) | 0.14 |
EDV, ME (LQ;UQ) mL | 147.0 (130.0;187.0) | 180.0 (147.0;194.0) | 0.028 |
EDVi, ME (LQ;UQ) mL/m2 | 78.9(70.33;96.5) | 87.67(81.17;93.14) | 0.126 |
ESV, ME (LQ;UQ) mL | 51.0 (43.0;70.0) | 70.0 (51.0;83.0) | 0.008 |
ESVi, ME (LQ;UQ) mL/m2 | 27.28(21.9;35.1) | 35.2(25.03;43.06) | 0.025 |
LVEF, ME (LQ;UQ) % | 61.0 (55.0;66.0) | 56.0 (50.0;62.0) | 0.005 |
SV, ME (LQ, UQ), mL | 147.0 (130.0;187.0) | 177.0 (150.5;194.0) | 0.271 |
LVM, ME (LQ;UQ) (g) | 304.3 (250.4;364.7) | 315.3 (288.7;428.8) | 0.243 |
LVMi, ME (LQ;UQ) | 152.5 (128.9;184.0) | 177.8 (151.3;243.5) | 0.172 |
IVST ME (LQ, UQ) cm | 1.1 (1.0;1.2) | 1.2 (1.0;1.4) | 0.128 |
PW LV, ME (LQ, UQ) cm | 1.1 (1.0;1.2) | 1.1 (1.0;1.3) | 0.361 |
Indicators of LV diastolic function | |||
IVRT, ME(LQ;UQ) m/s | 92.0 (90.0;98.0) | 94.0 (92.0;99.0) | 0.155 |
E, cm/sME (LQ, UQ) | 59.0 (45.0;68.0) | 52.0 (42.0;63.0) | 0.082 |
A, cm/s ME (LQ, UQ) | 67.0 (57.0;79.0) | 72.0 (63.0;77.0) | 0.667 |
E/A | 0.78 (0.66;1.13) | 0.76 (0.63;0.82) | 0.131 |
e’, cm/s, ME (LQ, UQ) | 9.0 (7.5;11.0) | 8.4 (7.5;11.9) | 0.529 |
a’, cm/sME (LQ, UQ) | 9.8 (8.4;11.6) | 10.8 (9.8;11.4) | 0.385 |
e’/a’, ME (LQ, UQ) | 0.9 (0.68;1.29) | 0.73 (0.66;1.2) | 0.264 |
s’, cm/s ME (LQ, UQ) | 9.0 (8.0;10.2) | 9.6 (8.4;11.6) | 0.308 |
E/e’, ME (LQ, UQ) | 6.14 (4.8;7.67) | 5.56 (4.62;6.91) | 0.165 |
Tei LV (LQ;UQ) | 0.32 (0.25;0.42) | 0.33 (0.26;0.41) | 0.954 |
Characteristics | Group 1 without MACE (n = 170) | Group 2 MACE (n = 19) | p |
---|---|---|---|
Structural indicators and systolic function | |||
RV, (LQ; UQ) mm | 2.0 (1.8;2.2) | 2.1 (2.0;2.4) | 0.063 |
RVth, (LQ; UQ) mm | 0.4 (0.3;0.4) | 0.4 (0.3;0.4) | 0.714 |
TAPSE, (LQ, UQ) mm | 23.0 (20.0;26.0) | 24.0 (22.0;28.0) | 0.261 |
RVEF, ME (LQ;UQ) % | 55.0 (52.0;57.0) | 54.0 (53.0;56.0) | 0.682 |
RA, ME (LQ; UQ) mm | 40.0 (32.0;49.0) | 43.0 (39.0;52.0) | 0.175 |
mPAP. (LQ; UQ) mmhg | 12.0 (11.0;13.0) | 15.0 (12.0;20.0) | 0.057 |
sPAP. (LQ; UQ) mmhg | 25.0 (24.0;29.0) | 28.0 (25.0;30.0) | 0.158 |
Indicators of RV diastolic function | |||
Et, ME (LQ, UQ) cm/s | 44.0 (37.0;49.0) | 44.0 (37.0;50.0) | 0.836 |
At, ME (LQ, UQ) cm/s | 42.0 (34.0;49.5) | 41.0 (37.0;48.0) | 0.759 |
Et/At | 1.1 (0.76;1.36) | 0.88 (0.78;1.35) | 0.934 |
e’t, ME (LQ, UQ) cm/s | 9.6 (8.4;11.3) | 8.2 (7.3;10.2) | 0.029 |
a’t, ME (LQ, UQ) cm/s | 14.0 (12.1;16.1) | 13.0 (10.8;15.6) | 0.239 |
e’t/a’t, ME (LQ, UQ) | 069 (0.59;0.79) | 0.68 (0.57;0.77) | 0.326 |
s’t, ME (LQ, UQ) cm/s | 13.1 (11.9;14.8) | 13.3 (11.8;15.0) | 0.926 |
Et/e’t, ME (LQ, UQ) | 4.42 (3.6;5.5) | 5.25 (3.98;6.85) | 0.049 |
RV Tei index (LQ; UQ) | 0.3 (0.23;0.38) | 0.3 (0.2;0.36) | 0.566 |
RVDD, n (%) | 73 (42.9) | 10 (52.6) | 0.449 |
- impaired relaxation, n (%) | 51 (30.0) | 4 (21.1) | 0.416 |
- pseudonormal filling, n (%) | 22 (12.9) | 6 (31.6) | 0.030 |
B | S.E. | Wald | df | Sig. | Exp(B) | |
---|---|---|---|---|---|---|
PCI | −1.937 | 0.957 | 4.100 | 1 | 0.043 | 0.144 |
PA | 1.770 | 0.670 | 6.965 | 1 | 0.008 | 5.868 |
IVST | 4.338 | 1.654 | 6.879 | 1 | 0.009 | 76.567 |
Et/e’t | 0.408 | 0.173 | 5.551 | 1 | 0.018 | 1.504 |
LVEF | −0.129 | 0.037 | 12.098 | 1 | 0.001 | 0.879 |
Constant | −1.827 | 2.342 | 0.609 | 1 | 0.435 | 0.161 |
B | S.E. | Wald | df | Sig. | Exp(B) | |
---|---|---|---|---|---|---|
NYHA III FC | 1.298 | 0.451 | 8.278 | 1 | 0.004 | 3.661 |
Arrhythmia | 0.905 | 0.454 | 3.965 | 1 | 0.046 | 2.471 |
Aspirin | −1.973 | 0.647 | 9.302 | 1 | 0.002 | 0.139 |
IVST | 3.444 | 1.190 | 8.373 | 1 | 0.004 | 31.308 |
Constant | −3.805 | 1.413 | 7.248 | 1 | 0.007 | 0.022 |
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Sumin, A.N.; Shcheglova, A.V.; Korok, E.V.; Sergeeva, T.J. The Outcomes of Coronary Artery Bypass Surgery after 18 Months—Is There an Influence of the Initial Right Ventricle Diastolic Dysfunction? J. Cardiovasc. Dev. Dis. 2023, 10, 18. https://doi.org/10.3390/jcdd10010018
Sumin AN, Shcheglova AV, Korok EV, Sergeeva TJ. The Outcomes of Coronary Artery Bypass Surgery after 18 Months—Is There an Influence of the Initial Right Ventricle Diastolic Dysfunction? Journal of Cardiovascular Development and Disease. 2023; 10(1):18. https://doi.org/10.3390/jcdd10010018
Chicago/Turabian StyleSumin, Alexey N., Anna V. Shcheglova, Ekaterina V. Korok, and Tatjana Ju. Sergeeva. 2023. "The Outcomes of Coronary Artery Bypass Surgery after 18 Months—Is There an Influence of the Initial Right Ventricle Diastolic Dysfunction?" Journal of Cardiovascular Development and Disease 10, no. 1: 18. https://doi.org/10.3390/jcdd10010018