Relationship between echocardiographic index of ventricular filling pressure and intraoperative haemodynamic changes during off-pump coronary bypass surgery

J. K. Shim, Y. S. Choi, D. H. Chun, S. W. Hong, D. H. Kim, Younglan Kwak

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: The ratio of mitral velocity to early-diastolic velocity of the mitral annulus (E/e′) is an indicator of diastolic function representing acute loading conditions of the left ventricle. We tested the efficacy of E/e′ as a predictor of haemodynamic derangement during off-pump coronary artery bypass surgery (OPCAB), when heart displacement causes loading changes. Methods and results: Fifty patients with left ventricular (LV) ejection fraction ≥50% were divided into two groups; E/e′<8 (normal LV filling pressure, n=25) and >15 (increased LV filling pressure, n=25). Haemodynamic measurements were recorded after induction of anaesthesia, during grafting, and after sternum closure. Patients' characteristics and operative data were similar between the groups. Cardiac index and mixed venous oxygen saturation were significantly lower during grafting and after sternum closure in the E/e′>15 group, compared with E/e′<8 group and with the baseline values. The E/e′>15 group required significantly longer ventilation time and length of stay in the intensive care unit. Conclusions: Even in patients with preserved systolic LV function, patients with E/e′>15 were more prone to undergo a significant decrease in cardiac output during OPCAB, which did not return to baseline level after completion of grafting. Whether this finding is associated with increased morbidity and mortality should be validated.

Original languageEnglish
Pages (from-to)316-321
Number of pages6
JournalBritish Journal of Anaesthesia
Volume102
Issue number3
DOIs
Publication statusPublished - 2009 Jan 1

Fingerprint

Ventricular Pressure
Hemodynamics
Off-Pump Coronary Artery Bypass
Sternum
Coronary Artery Bypass
Left Ventricular Function
Cardiac Output
Stroke Volume
Heart Ventricles
Intensive Care Units
Ventilation
Length of Stay
Anesthesia
Oxygen
Morbidity
Mortality

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

@article{0eb017cdf1e745a38bdd0e1d3bc50ac0,
title = "Relationship between echocardiographic index of ventricular filling pressure and intraoperative haemodynamic changes during off-pump coronary bypass surgery",
abstract = "Background: The ratio of mitral velocity to early-diastolic velocity of the mitral annulus (E/e′) is an indicator of diastolic function representing acute loading conditions of the left ventricle. We tested the efficacy of E/e′ as a predictor of haemodynamic derangement during off-pump coronary artery bypass surgery (OPCAB), when heart displacement causes loading changes. Methods and results: Fifty patients with left ventricular (LV) ejection fraction ≥50{\%} were divided into two groups; E/e′<8 (normal LV filling pressure, n=25) and >15 (increased LV filling pressure, n=25). Haemodynamic measurements were recorded after induction of anaesthesia, during grafting, and after sternum closure. Patients' characteristics and operative data were similar between the groups. Cardiac index and mixed venous oxygen saturation were significantly lower during grafting and after sternum closure in the E/e′>15 group, compared with E/e′<8 group and with the baseline values. The E/e′>15 group required significantly longer ventilation time and length of stay in the intensive care unit. Conclusions: Even in patients with preserved systolic LV function, patients with E/e′>15 were more prone to undergo a significant decrease in cardiac output during OPCAB, which did not return to baseline level after completion of grafting. Whether this finding is associated with increased morbidity and mortality should be validated.",
author = "Shim, {J. K.} and Choi, {Y. S.} and Chun, {D. H.} and Hong, {S. W.} and Kim, {D. H.} and Younglan Kwak",
year = "2009",
month = "1",
day = "1",
doi = "10.1093/bja/aep005",
language = "English",
volume = "102",
pages = "316--321",
journal = "British Journal of Anaesthesia",
issn = "0007-0912",
publisher = "Oxford University Press",
number = "3",

}

Relationship between echocardiographic index of ventricular filling pressure and intraoperative haemodynamic changes during off-pump coronary bypass surgery. / Shim, J. K.; Choi, Y. S.; Chun, D. H.; Hong, S. W.; Kim, D. H.; Kwak, Younglan.

In: British Journal of Anaesthesia, Vol. 102, No. 3, 01.01.2009, p. 316-321.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Relationship between echocardiographic index of ventricular filling pressure and intraoperative haemodynamic changes during off-pump coronary bypass surgery

AU - Shim, J. K.

AU - Choi, Y. S.

AU - Chun, D. H.

AU - Hong, S. W.

AU - Kim, D. H.

AU - Kwak, Younglan

PY - 2009/1/1

Y1 - 2009/1/1

N2 - Background: The ratio of mitral velocity to early-diastolic velocity of the mitral annulus (E/e′) is an indicator of diastolic function representing acute loading conditions of the left ventricle. We tested the efficacy of E/e′ as a predictor of haemodynamic derangement during off-pump coronary artery bypass surgery (OPCAB), when heart displacement causes loading changes. Methods and results: Fifty patients with left ventricular (LV) ejection fraction ≥50% were divided into two groups; E/e′<8 (normal LV filling pressure, n=25) and >15 (increased LV filling pressure, n=25). Haemodynamic measurements were recorded after induction of anaesthesia, during grafting, and after sternum closure. Patients' characteristics and operative data were similar between the groups. Cardiac index and mixed venous oxygen saturation were significantly lower during grafting and after sternum closure in the E/e′>15 group, compared with E/e′<8 group and with the baseline values. The E/e′>15 group required significantly longer ventilation time and length of stay in the intensive care unit. Conclusions: Even in patients with preserved systolic LV function, patients with E/e′>15 were more prone to undergo a significant decrease in cardiac output during OPCAB, which did not return to baseline level after completion of grafting. Whether this finding is associated with increased morbidity and mortality should be validated.

AB - Background: The ratio of mitral velocity to early-diastolic velocity of the mitral annulus (E/e′) is an indicator of diastolic function representing acute loading conditions of the left ventricle. We tested the efficacy of E/e′ as a predictor of haemodynamic derangement during off-pump coronary artery bypass surgery (OPCAB), when heart displacement causes loading changes. Methods and results: Fifty patients with left ventricular (LV) ejection fraction ≥50% were divided into two groups; E/e′<8 (normal LV filling pressure, n=25) and >15 (increased LV filling pressure, n=25). Haemodynamic measurements were recorded after induction of anaesthesia, during grafting, and after sternum closure. Patients' characteristics and operative data were similar between the groups. Cardiac index and mixed venous oxygen saturation were significantly lower during grafting and after sternum closure in the E/e′>15 group, compared with E/e′<8 group and with the baseline values. The E/e′>15 group required significantly longer ventilation time and length of stay in the intensive care unit. Conclusions: Even in patients with preserved systolic LV function, patients with E/e′>15 were more prone to undergo a significant decrease in cardiac output during OPCAB, which did not return to baseline level after completion of grafting. Whether this finding is associated with increased morbidity and mortality should be validated.

UR - http://www.scopus.com/inward/record.url?scp=60249089029&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=60249089029&partnerID=8YFLogxK

U2 - 10.1093/bja/aep005

DO - 10.1093/bja/aep005

M3 - Article

C2 - 19203992

AN - SCOPUS:60249089029

VL - 102

SP - 316

EP - 321

JO - British Journal of Anaesthesia

JF - British Journal of Anaesthesia

SN - 0007-0912

IS - 3

ER -