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- W2000336813 abstract "Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery, with increased risk of embolic events, haemodynamic instability, haemorrhagic complications and prolonged hospital stay. We sought to assess the value of preoperative left ventricular global longitudinal strain (GLS) for the prediction of POAF in a series of patients with severe symptomatic aortic stenosis who underwent aortic valve replacement (AVR). Fifty-eight consecutive patients (52% men) aged 73 ± 9 years, with severe symptomatic aortic stenosis (aortic valve area < 1 cm2 or < 0.5 cm2/m2), in sinus rhythm, who underwent AVR were prospectively included in three centres between 2009 and 2010. Complete preoperative echocardiography was performed in all patients, including global and segmental longitudinal strain using two-dimensional speckle tracking. The POAF incidence was 28/58 (48%). On univariate analysis, aortic valve area (P = 0.04), preoperative E/e’ ratio (P = 0.04) and GLS (P = 0.005) were associated with the occurrence of POAF. Chronic obstructive pulmonary disease (P = 0.05), preoperative statin treatment (P = 0.09), age ≥ 80 years (P = 0.09), left ventricular ejection fraction (P = 0.09) and systolic pulmonary artery pressure (P = 0.06) tended to increase the risk of POAF. The best GLS cut-off value for the prediction of POAF was –15% (82% sensitivity, 53% specificity, area under the curve 0.72). On multivariable analysis, GLS > –15% was the only independent predictor of POAF (odds ratio 7.74, 95% confidence interval [1.15–52.03]; P = 0.035). Incidence of POAF is high after AVR for severe aortic stenosis. Our results suggest an additive value of the study of left ventricular myocardial deformation to classical clinical and echocardiographic variables for the prediction of POAF in this setting. La fibrillation atriale postopératoire (FAPO) est une complication courante après chirurgie cardiaque, augmentant le risque d’épisodes emboliques, hémorragiques, d’instabilité hémodynamique, prolongeant l’hospitalisation. Évaluer l’apport de l’étude de la déformation longitudinale du ventricule gauche en utilisant l’imagerie bidimensionnelle (strain global longitudinal [SGL]) pour prédire la survenue de la FAPO après remplacement valvulaire aortique (RVA) pour rétrécissement aortique serré (RAC) symptomatique. Cinquante-huit patients consécutifs (52 % d’hommes), âgés de 73 ± 9 ans, porteurs d’un RAC serré symptomatique (défini par une surface aortique < 1 cm2 ou < 0,5 cm2/m2), en rythme sinusal, et opérés d’un RVA ont été inclus prospectivement dans trois centres entre 2009 and 2010. Une échocardiographie complète incluant le SGL a été realisée avant chirurgie chez tous les patients. L’incidence de la FAPO était de 28/58 (48 %). En analyse univariée, la surface aortique (p = 0,04), le rapport E/e’ préopératoire (p = 0,04) et le SGL (p = 0,005) étaient associés à la survenue de FAPO. La bronchopathie obstructive chronique (p = 0,05), le traitement par statine en préopératoire (p = 0,09), l’âge ≥ 80 ans (p = 0,09), la fraction d’éjection ventriculaire gauche (p = 0,09) et la pression artérielle pulmonaire systolique (p = 0,06) tendaient vers la significativité pour prédire la FAPO. Le meilleur seuil de SGL pour prédire la FAPO était de –15 % (82 % de sensitivité, 53 % de spécificité, aire sous la courbe 0,72). En l’analyse multivariée, le SGL supérieur à –15 % était le seul prédicteur indépendant de FAPO (OR 7,74 [1,15–52,03], p = 0,035). La FAPO est fréquente après RVA pour RAC serré. Nos résultats suggèrent une valeur additionnelle de l’étude de la déformation longitudinale du ventricule gauche par imagerie échographique bidimensionnelle aux paramètres cliniques et échographiques classiques pour prédire la FAPO." @default.
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- W2000336813 date "2012-10-01" @default.
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- W2000336813 title "Echocardiographic prediction of postoperative atrial fibrillation after aortic valve replacement for aortic stenosis: A two-dimensional speckle tracking left ventricular longitudinal strain multicentre pilot study" @default.
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- W2000336813 doi "https://doi.org/10.1016/j.acvd.2012.06.002" @default.
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