scholarly journals Role of LA strain assessed by speckle tracking echocardiography in predicting patients who develop POAF after a coronary artery bypass surgery

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
V Rukmani Prabha ◽  
N Rajeshwari ◽  
J Jenifer
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Left Atrial ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Artery Bypass ◽  
Coronary Risk Factors ◽  
Global Strain ◽  
The Mean

Abstract Objectives To evaluate the correlation between left atrial dysfunction assessed by speckle tracking echocardiography and development of postoperative atrial fibrillation (POAF) in patients undergoing coronary artery bypass grafting. To determine the role of coronary risk factors in development of POAF. Method Patients undergoing CABG from January 2019 till June 2020 in Apollo institute, fulfilling the inclusion and exclusion criteria were included.Total of 200 patients were followed.They were subjected to LA strain and strain rate analysis by speckle tracking. Results The incidence of POAF in our study was 24% (n=48). The mean age of this study population was 59.13 years. The patients who developed POAF were older (68.5±9.048 vs 58.39±9.74 years, p value=0.05) than those with no POAF. POAF occurred in 2 phases. the highest proportion of POAF occurrence noticed on postoperative day 2. Among the total POAF cases 79.% occurred within the first 48 hours and 20.8% occurred later (p=0.001). Among the 48 patients who developed POAF, 5 of them developed recurrence during their hospital stay. They had reverted to sinus rhythm following anti-arrhythmic medication for a duration of >24 hours, but went on to develop recurrence of AF at a later. 4 among them reverted to sinus rhythm at discharge while 1 continued to remain in AF at discharge.The duration of hospital stay for patients with POAF group was 10.4 days compared with 10.04 days for those without POAF. Similarly the post-operative stay in the hospital was 7.4 days for the POAF group and 7.04 days for the NO POAF.There was no added economic impact secondary to AF.Comparing the values of left atrial volume index of both the groups it was derived that the mean LAVI value of the POAF group was 26.84+3.654 ml/m2 and that for the NO POAF group was 26.6+3.037ml/m2. Though the patients with POAF had larger LA volume, the chi square test analysis did not yield any clinically significant relationship between LAVI and POAF in our study (p=0.3). The mean LA global strain for the patients with POAF was 29.73+3.695%. And for the patients with no POAF was 36.3+4.854%. LA global strain was reduced in patients who developed POAF (P<0.001) which indicated a strong correlation between LA strain and POAF. Conclusion There is significant correlation between Global Left Atrial Strain and POAF in patients undergoing CABG (P<0.001).There is no significant correlation between patient factors like age, BMI, and the conventional coronary risk factors with POAFThere is no significant correlation between the conventional echocardiographic parameters like LA diameter, LAVI, LVDD, LVSD, LVEF and transmitral flow velocities with POAF. To conclude, preoperative speckle tracking assessment of LA has a strong predictive role in determining the occurrence of POAF in patients undergoing Coronary artery bypass grafting surgery. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Early systolic lengthening by speckle tracking echocardiography predicts outcome after coronary artery bypass surgery

2021 ◽  
Vol 34 ◽  
pp. 100799
Author(s):  
Philip Brainin ◽  
Søren Lindberg ◽  
Flemming J. Olsen ◽  
Sune Pedersen ◽  
Allan Iversen ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Speckle Tracking ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Speckle Tracking Echocardiography ◽  
Artery Bypass

scholarly journals Predictors of postoperative atrial fibrillation after coronary artery bypass grafting: a prospective observational cohort study

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Hanaa A. El-Gendy ◽  
Mohamed H. Dabsha ◽  
Gamal M. Elewa ◽  
Amr H. Ali
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Valve Replacement ◽  
Left Atrial ◽  
Potassium Level ◽  
Artery Bypass ◽  
Female Gender ◽  
Inotropic Support ◽  
The Mean

Abstract Background This study was conducted to determine the effect of certain predictors on the incidence of postoperative atrial fibrillation (POAF) during ICU stay after coronary artery bypass graft (CABG) surgery. Results We enrolled 123 patients in this study. The mean age was 57.4 ± 8.7 years, and the mean left atrial diameter was 4.1 ± 0.52 cm with male preponderance (76.4%). The incidence of POAF following CABG was 33.3%. There was no statistically significant association between POAF and smoking (P = 0.123). However, POAF was significantly associated with higher CHA2DS2-VASc score (P = 0.002), valve replacement (P < 0.001), and inotropic support (P = 0.005). Moreover, patients with POAF had significantly higher mean age (P = 0.031) and left atrial (LA) diameter (P < 0.001). Logistic regression showed that LA diameter (P < 0.001), potassium level at 36 h (P = 0.016), and female gender (P = 0.001) were independent predictors of POAF. Conclusions We had several significant epidemiological, clinical, and operative variables that were significantly associated with post-CABG AF, including older age, female gender, large LA diameter, valve replacement, higher CHA2DS2-VASc score, and postoperative inotropic support. However, only LA diameter, female gender, and potassium level at 36 h were independent predictors of POAF. Nevertheless, further large-scale studies are needed to confirm our findings.

scholarly journals Psychological evaluation by using the Hamilton depression and anxiety rating scales in coronary artery bypass grafting patients undergoing cardiovascular rehabilitation treatment

2020 ◽  
Vol 30 (1) ◽  
pp. 30-34
Author(s):  
Razan Al Namat ◽  
Maura Felea ◽  
Amin Bazyani ◽  
Liviu Macovei ◽  
Marius Adoamnei ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Risk Scores ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Cardiovascular Rehabilitation ◽  
The Mean

Cardiovascular disease is one of the leading causes of morbid-mortality, although better outcomes and lower mortality of age-adjusted coronary artery disease were registered since 1980s, especially in high-income populations, sustaining the cost effective of cardiac prevention methods. The aim of this prospective study was to evaluate the role of cardiac rehabilitation in improving psycho-emotional risk scores: the Hamilton Depression (HAM-D) and Anxiety Rating Scale (HAM-A) in coronary artery bypass grafting (CABG) patients, in less than one week after cardiovascular surgery and in 6 months follow-up after the engagement in the cardiac recovery program. Methods – During 01.05.2015 – 01.03.2017, CABG was performed in 100 patients, aged 40-80 years old, who followed rehabilitation in the Cardiovascular Rehabilitation Clinic. The mean age of the patients under study was 65.70 ± 9.91 years old. Results – In the fi rst phase of the cardiovascular rehabilitation program, the mean values were: 16 points for HAM-D, and 25 points on HAM-A scale. By comparing the Phase I and Phase III results, the median HAM-D score improved more than 50%, and HAM-A about 36% (p<0.05). Conclusion – The study highlighted the role of early rehabilitation after CABG surgery and the HAM-D and HAM-A scores improvement, emphasizing the importance of including psycho-emotional status assessment in the management of the patient who benefi ted from cardiac surgery. Apart from clinical data and the cardiovascular risk scores, the psycho-emotional risk stratification can provide important information regarding outcomes and prognosis.

scholarly journals Strain and strain rate echocardiographic imaging predict occurrence of atrial fibrillation in post-coronary artery bypass grafting patients

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Gomaa Abdelrazek ◽  
Kareem Mandour ◽  
Mohammad Osama ◽  
Khaled Elkhashab
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Strain Rate ◽  
Coronary Artery Bypass ◽  
Left Atrial ◽  
Speckle Tracking ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Diastolic Strain Rate

Abstract Background Atrial fibrillation (AF) occurs very frequently after coronary artery bypass grafting (CABG); it occurs in about 20–edictors can be used for the dedicatio40% of patients. It is associated with several adverse events. This study aimed to extrapolate a predictor for postoperative atrial fibrillation (POAF) occurrence which is reproducible and simple to be a part of routine echocardiography screening before CABG. This study included 89 patients scheduled for isolated coronary artery bypass surgery. History, clinical examination, and complete 2D echocardiography with LA speckle tracking analysis were done preoperatively. Patients were then followed up post-surgery for incidence of AF till discharge from the hospital. The patients were divided into 2 groups according to POAF occurrence. Results Patients who developed postoperative AF had older age (P = 0.0032) and longer hospital stay (P = 0.021) and higher stroke incidence but statistically non-significant (14.3% vs 3.3%). The POAF patients showed less peak atrial longitudinal strain (PALS) value than non-POAF patients. The left atrial strain rate values showed a significant difference with the lower left atrial systolic strain rate and less negative (higher) early diastolic strain rate and late diastolic strain rate. After multivariate logistic regression analysis, the independent predictors for POAF were PALS (OR 0.770, 95% CI 0.627–0.946), late LA diastolic strain rate (LASRa) (OR 3.476, 95% CI 1.207–12.186), and age (OR 1.181, 95% CI 1.011–1.379). Conclusion Preoperative LA global strain assessed by 2D speckle tracking analysis could be helpful as a predictor for AF post-CABG surgery, and identification of these patients may reduce its morbidity and mortality. The study suggested PALS value less than 29.8 to be a predictor for the occurrence of POAF.

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