TY - JOUR

T1 - Взаимосвязь между характеристиками диастолической функции и тяжелым повреждением миокарда при операциях шунтирования коронарных артерий в условиях искусственного кровообращения: ретроспективное когортное исследование

AU - Efremov, S.M.

AU - Shmidt, R.E.

AU - Zyryanova, A.V.

AU - Shmidt, T.A.

AU - Kamenskih, M.S.

AU - Shmatov, D.V.

PY - 2024

Y1 - 2024

N2 - Introduction: The clinical significance of parameters characterizing left ventricular diastolic function after cardiac surgery has not been sufficiently studied. Objective: The study was aimed to test the hypothesis about the relationship between echocardiographic parameters of left ventricular diastolic function and the severe perioperative myocardial injury.Methods: This retrospective cohort study included 220 patients who underwent isolated coronary artery bypass surgery under cardiopulmonary bypass. We analyzed the degree of diastolic dysfunction, and transmittal blood flow characteristics including left ventricular early diastolic filling velocity (E-wave), and the ratio of E-wave to left atrial systole filling velocity (E/A), left atrial volume index, tricuspid regurgitation velocity, mean mitral valve annulus velocity (e'), and E/e' ratio according to echocardiography before and after surgery. Severe perioperative myocardial injury (the primary outcome) was identified when the high-sensitivity troponin I concentration reached a level greater than 5,670 ng/L on the first day after surgery.Results: ROC analysis showed that E-wave greater than 71 cm/s and E/A greater than 1.3 were associated with severe perioperative myocardial injury. In addition, diastolic dysfunction of grade 2 and 3 was found in 13.1% of patients with postoperative troponin I levels less than 5,670 ng/L and in 42.9% of patients with levels greater than 5,670 ng/L (P = 0.009). Conclusion: Postoperative degree of diastolic dysfunction and transmitral blood flow parameters are associated with prognostically unfavorable troponin I levels. Received 26 January 2024. Revised 31 July 2024. Accepted 2 August 2024. FundingThe study did not have sponsorship. Conflict of interestThe authors declare no conflict of interest. Contribution of the authorsConception and study design: S.M. EfremovData collection and analysis: S.M. Efremov, R.E. Shmidt, T.A. Shmidt, A.V. ZyryanovaStatistical analysis: S.M. Efremov, R.E. ShmidtDrafting the article: S.M. Efremov, R.E. Shmidt, A.V. ZyryanovaCritical revision of the article: S.M. Efremov, R.E. Shmidt, A.V. Zyryanova, T.A. Shmidt, M.S. Kamenskih, D.V. ShmatovFinal approval of the version to be published: S.M. Efremov, R.E. Shmidt, A.V. Zyryanova, T.A. Shmidt, M.S. Kamenskih, D.V. Shmatov

AB - Introduction: The clinical significance of parameters characterizing left ventricular diastolic function after cardiac surgery has not been sufficiently studied. Objective: The study was aimed to test the hypothesis about the relationship between echocardiographic parameters of left ventricular diastolic function and the severe perioperative myocardial injury.Methods: This retrospective cohort study included 220 patients who underwent isolated coronary artery bypass surgery under cardiopulmonary bypass. We analyzed the degree of diastolic dysfunction, and transmittal blood flow characteristics including left ventricular early diastolic filling velocity (E-wave), and the ratio of E-wave to left atrial systole filling velocity (E/A), left atrial volume index, tricuspid regurgitation velocity, mean mitral valve annulus velocity (e'), and E/e' ratio according to echocardiography before and after surgery. Severe perioperative myocardial injury (the primary outcome) was identified when the high-sensitivity troponin I concentration reached a level greater than 5,670 ng/L on the first day after surgery.Results: ROC analysis showed that E-wave greater than 71 cm/s and E/A greater than 1.3 were associated with severe perioperative myocardial injury. In addition, diastolic dysfunction of grade 2 and 3 was found in 13.1% of patients with postoperative troponin I levels less than 5,670 ng/L and in 42.9% of patients with levels greater than 5,670 ng/L (P = 0.009). Conclusion: Postoperative degree of diastolic dysfunction and transmitral blood flow parameters are associated with prognostically unfavorable troponin I levels. Received 26 January 2024. Revised 31 July 2024. Accepted 2 August 2024. FundingThe study did not have sponsorship. Conflict of interestThe authors declare no conflict of interest. Contribution of the authorsConception and study design: S.M. EfremovData collection and analysis: S.M. Efremov, R.E. Shmidt, T.A. Shmidt, A.V. ZyryanovaStatistical analysis: S.M. Efremov, R.E. ShmidtDrafting the article: S.M. Efremov, R.E. Shmidt, A.V. ZyryanovaCritical revision of the article: S.M. Efremov, R.E. Shmidt, A.V. Zyryanova, T.A. Shmidt, M.S. Kamenskih, D.V. ShmatovFinal approval of the version to be published: S.M. Efremov, R.E. Shmidt, A.V. Zyryanova, T.A. Shmidt, M.S. Kamenskih, D.V. Shmatov

KW - 2024

KW - ICU

KW - Q4

KW - Scopus

U2 - 10.21688/1681-3472-2024-2-51-61

DO - 10.21688/1681-3472-2024-2-51-61

M3 - статья

VL - 28

SP - 51

EP - 61

JO - Patologiya Krovoobrashcheniya i Kardiokhirurgiya

JF - Patologiya Krovoobrashcheniya i Kardiokhirurgiya

SN - 1681-3472

IS - 2

ER -