ArticleCritical care (London, England)2010
Preoperative diastolic function predicts the onset of left ventricular dysfunction following aortic valve replacement in high-risk patients with aortic stenosis.
Article in Critical care (London, England), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Diastolic dysfunction and mortality in septic patients: a systematic review and meta-analysis.Intensive care medicine · 2015Pooled it
- Glucose-insulin-potassium improves left ventricular performances after aortic valve replacement: a secondary analysis of a randomized controlled trial.BMC anesthesiology · 2019Trial
- Incidence and Risk Factors for Long-Term Persistence of Diastolic Dysfunction after Aortic Valve Replacement for Aortic Stenosis Compared with Aortic Regurgitation.Journal of cardiovascular development and disease · 2023Article
- Additional Prognostic Value of Tissue Doppler Evaluation in Patients with Aortic Stenosis and Left-Ventricular Systolic Dysfunction Undergoing Aortic Valve Replacement.Medicina (Kaunas, Lithuania) · 2022Article
- Evaluation of left ventricular diastolic function in patients operated for aortic stenosis.PloS one · 2022Observational
- Consensus Defined Diastolic Dysfunction and Cardiac Postoperative Morbidity Score: A Prospective Observational Study.Journal of clinical medicine · 2021Article
- Prediction of all-cause mortality after liver transplantation using left ventricular systolic and diastolic function assessment.PloS one · 2019Article
- Practical approach to diastolic dysfunction in light of the new guidelines and clinical applications in the operating room and in the intensive care.Annals of intensive care · 2018Review
- Echo for diastology.Annals of cardiac anaesthesia · 2016Review
- One problem two issues! Left ventricular systolic and diastolic dysfunction in aortic stenosis.Annals of translational medicine · 2014Review
- B-type natriuretic peptide as a biochemical marker of left ventricular diastolic function: assessment in asymptomatic patients 1 year after valve replacement for aortic stenosis.Interactive cardiovascular and thoracic surgery · 2013Article
- Intraoperative cardiac assessment with transesophageal echocardiography for decision-making in cardiac anesthesia.General thoracic and cardiovascular surgery · 2013Review
- New insights into weaning from mechanical ventilation: left ventricular diastolic dysfunction is a key player.Intensive care medicine · 2011Article
- Rationale, design and methodology for Intraventricular Pressure Gradients Study: a novel approach for ventricular filling assessment in normal and falling hearts.Journal of cardiothoracic surgery · 2011Article
- Year in review 2010: Critical Care--Cardiology.Critical care (London, England) · 2011Review
- Risk factors of postcardiotomy ventricular dysfunction in moderate-to-high risk patients undergoing open-heart surgery.Annals of cardiac anaesthesiaArticle
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionLeft ventricular (LV) dysfunction frequently occurs after cardiac surgery, requiring inotropic treatment and/or mechanical circulatory support. In this study, we aimed to identify clinical, surgical and echocardiographic factors that are associated with LV dysfunction during weaning from cardiopulmonary bypass (CPB) in high-risk patients undergoing valve replacement for aortic stenosis.
methodsPerioperative data were prospectively collected in 108 surgical candidates with an expected operative mortality >or=9%. All anesthetic and surgical techniques were standardized. Reduced LV systolic function was defined by an ejection fraction <40%. Diastolic function of the LV was assessed using standard Doppler-derived parameters, tissue Doppler Imaging (TDI) and transmitral flow propagation velocity (Vp).
resultsDoppler-derived pulmonary flow indices and TDI could not be obtained in 14 patients. In the remaining 94 patients, poor systolic LV was documented in 14% (n = 12) and diastolic dysfunction in 84% of patients (n = 89), all of whom had Vp <50 cm/s. During weaning from CPB, 38 patients (40%) required inotropic and/or mechanical circulatory support. By multivariate regression analysis, we identified three independent predictors of LV systolic dysfunction: age (Odds ratio [OR] = 1.11; 95% confidence interval (CI), 1.01 to 1.22), aortic clamping time (OR = 1.04; 95% CI, 1.00 to 1.08) and Vp (OR = 0.65; 95% CI, 0.52 to 0.81). Among echocardiographic measurements, Vp was found to be superior in terms of prognostic value and reliability. The best cut-off value for Vp to predict LV dysfunction was 40 cm/s (sensitivity of 72% and specificity 94%). Patients who experienced LV dysfunction presented higher in-hospital mortality (18.4% vs. 3.6% in patients without LV dysfunction, P = 0.044) and an increased incidence of serious cardiac events (81.6 vs. 28.6%, P < 0.001).
conclusionsThis study provides the first evidence that, besides advanced age and prolonged myocardial ischemic time, LV diastolic dysfunction characterized by Vp <or= 40 cm/sec identifies patients who will require cardiovascular support following valve replacement for aortic stenosis.
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