Myocardial Blush Grade Predicts Postoperative Atrial Fibrillation following Mitral Valve Replacement: A Novel Perspective
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Evaluation of Myocardial Blush Grading
2.3. Postoperative Atrial Fibrillation
2.4. Statistical Analysis
3. Results
4. Discussion
Study Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Study Population (n = 188) | PoAF (+) (n = 64) | PoAF (−) (n = 124) | p Value |
---|---|---|---|---|
Age (years) | 56.69 ± 8.9 | 58.8 ± 6.07 | 55.6 ± 9.9 | 0.007 |
Male gender | 74 (39.4) | 26 (40.6) | 48 (38.7) | 0.799 |
BMI (kg/m2) | 26.36 ± 3.54 | 26.29 ± 3.53 | 26.4 ± 3.56 | 0.831 |
Hypertension | 43 (22.9) | 19 (29.7) | 24 (19.4) | 0.157 |
Hyperlipidemia | 23 (12.2) | 9 (14.1) | 14 (11.3) | 0.753 |
Diabetes mellitus | 25 (13.3) | 11 (17.2) | 14 (11.3) | 0.367 |
COPD | 40 (21.3) | 16 (25) | 24 (19.4) | 0.479 |
Current smoking | 22 (11.7) | 9 (14.1) | 13 (10.5) | 0.628 |
Preoperative NYHA status | 1.97 ± 0.58 | 2.02 ± 0.49 | 1.94 ± 0.63 | 0.387 |
Preoperative ACEi/ARB use | 40 (21.3) | 17 (26.6) | 23 (18.5) | 0.278 |
Preoperative statin use | 22 (11.7) | 9 (14.1) | 13 (10.5) | 0.628 |
Preoperative EF | 56.5 (49–63.75) | 55 (50–60) | 60 (48–65) | 0.34 |
Preoperative LVEDD | 5.65 (5.3–6.1) | 5.8 (5.4–6.2) | 5.6 (5.2–6.1) | 0.04 |
Preoperative LVESD | 4.1 (3.8–4.4) | 4.1 (4–4.5) | 4 (3.73–4.3) | 0.045 |
Preoperative SPAP (mmHg) | 45 (38–53.5) | 44.5 (35.25–50) | 45 (38–54.75) | 0.669 |
Preoperative LA diameter (cm) | 5.15 (4.63–6.1) | 5.9 (5.2–6.47) | 4.9 (4.5–5.8) | <0.001 |
Preoperative WBC (×109/L) | 8.34 ± 1.65 | 8.49 ± 1.78 | 8.27 ± 1.59 | 0.393 |
Preoperative hemoglobin (g/dL) | 13.84 ± 1.25 | 12.64 ± 0.89 | 14.46 ± 0.91 | <0.001 |
Preoperative ALT (U/L) | 41.5 (35–48) | 43 (36–51) | 41 (35–46.75) | 0.15 |
Preoperative AST (U/L) | 36 (31–44.75) | 35 (31–43.7) | 37 (31.25–45) | 0.503 |
Preoperative urea (mg/dL) | 35 (29–43) | 35 (30.25–42.75) | 35 (28.25–43) | 0.705 |
Preoperative creatinine (mg/dL) | 0.83 (0.76–0.9) | 0.82 (0.76–0.86) | 0.83 (0.77–0.98) | 0.074 |
Preoperative TSH (mIU/L) | 2.3 (1.66–2.8) | 2.3 (1.53–2.6) | 2.35 (1.7–3.1) | 0.101 |
Operation type | ||||
MVR | 134 (71.3) | 47 (73.4) | 87 (70.2) | 0.764 |
MVR + tricuspid annuloplasty | 54 (28.7) | 17 (26.6) | 37 (29.8) | |
Prosthetic valve size (mm) | 29 (27–31) | 29 (27–31) | 29 (27–31) | 0.088 |
CPB time (minutes) | 102.89 ± 20.22 | 108.19 ± 14.17 | 100.15 ± 22.29 | 0.003 |
X-clamp time (minutes) | 74.66 ± 16.13 | 78.81 ± 10.96 | 72.52 ± 17.9 | 0.003 |
Postoperative inotrope | 35 (18.6) | 14 (21.9) | 21 (16.9) | 0.531 |
Postop hospital length (days) | 6.44 ± 1.02 | 7.2 ± 0.93 | 6.05 ± 0.83 | <0.001 |
PoAF (+) (n = 64) | PoAF (−) (n = 124) | p Value | |
---|---|---|---|
Left anterior descending artery | |||
1 | 1 (1.6) | - | |
2 | 14 (21.9) | 3 (2.4) | <0.001 |
3 | 49 (76.6) | 121 (97.6) | |
Circumflex artery | |||
1 | 4 (6.3) | - | |
2 | 8 (12.5) | 4 (3.2) | <0.001 |
3 | 52 (81.3) | 120 (96.8) | |
Right coronary artery | |||
2 | 11 (17.2) | 6 (4.8) | 0.005 |
3 | 53 (82.8) | 118 (95.2) |
Study Population (n = 188) | PoAF (+) (n = 64) | PoAF (−) (n = 124) | p Value | |
---|---|---|---|---|
Left anterior descending artery | 2.9 ± 0.32 | 2.75 ± 0.47 | 2.98 ± 0.15 | <0.001 |
Circumflex artery | 2.89 ± 0.37 | 2.75 ± 0.56 | 2.97 ± 0.18 | 0.004 |
Right coronary artery | 2.91 ± 0.29 | 2.83 ± 0.38 | 2.95 ± 0.21 | 0.018 |
Total blush score | 8.7 ± 0.61 | 8.33 ± 0.84 | 8.9 ± 0.31 | <0.001 |
Difference | |||||
---|---|---|---|---|---|
n | Agreement | MBG 1 | MBG 2 | MBG 3 | |
Intraobserver variability | 40 | 38 (95) | 1 (2.5) | 1 (2.5) | - |
Interobserver variability | 40 | 38 (95) | 2 (5) | - | - |
Variable | Univariate Analysis | ||
---|---|---|---|
OR | 95% CI | p | |
Age | 1.042 | (1.006–1.078) | 0.021 |
Hypertension | 1.759 | (0.876–3.533) | 0.112 |
Preoperative LVEDD | 1.648 | (0.968–2.806) | 0.066 |
Preoperative LVESD | 1.768 | (0.992–3.15) | 0.053 |
Preoperative LA diameter | 2.758 | (1.869–4.071) | <0.001 |
Preoperative hemoglobin | 0.091 | (0.045–0.185) | <0.001 |
CPB time | 1.021 | (1.005–1.037) | 0.011 |
X-clamp time | 1.025 | (1.005–1.045) | 0.012 |
Abnormal MBG score for LAD | 12.347 | (3.422–44.552) | <0.001 |
Abnormal MBG score for Cx | 6.923 | (2.133–22.473) | 0.001 |
Abnormal MBG score for RCA | 4.082 | (1.434–11.62) | 0.008 |
Abnormal total blush score | 44.489 | (5.758–343.728) | <0.001 |
Variable | Multivariate Analysis | ||
---|---|---|---|
OR | 95% CI | p | |
Preoperative LA diameter | 2.057 | (1.166–3.63) | 0.013 |
Preoperative hemoglobin | 0.12 | (0.058–0.245) | <0.001 |
CPB time | 1.025 | (0.996–1.055) | 0.096 |
Abnormal total blush score | 15.1 | (1.602–142.339) | 0.018 |
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Çiçek, Ö.F.; Esenboğa, K.; Yalçın, M.U.; Durdu, M.S.; Altunkeser, B.B.; Büyükateş, M. Myocardial Blush Grade Predicts Postoperative Atrial Fibrillation following Mitral Valve Replacement: A Novel Perspective. J. Cardiovasc. Dev. Dis. 2023, 10, 275. https://doi.org/10.3390/jcdd10070275
Çiçek ÖF, Esenboğa K, Yalçın MU, Durdu MS, Altunkeser BB, Büyükateş M. Myocardial Blush Grade Predicts Postoperative Atrial Fibrillation following Mitral Valve Replacement: A Novel Perspective. Journal of Cardiovascular Development and Disease. 2023; 10(7):275. https://doi.org/10.3390/jcdd10070275
Chicago/Turabian StyleÇiçek, Ömer Faruk, Kerim Esenboğa, Muhammed Ulvi Yalçın, Mustafa Serkan Durdu, Bülent Behlül Altunkeser, and Mustafa Büyükateş. 2023. "Myocardial Blush Grade Predicts Postoperative Atrial Fibrillation following Mitral Valve Replacement: A Novel Perspective" Journal of Cardiovascular Development and Disease 10, no. 7: 275. https://doi.org/10.3390/jcdd10070275