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  • Open Access

Preoperative tissue Doppler imaging and diastolic filling patterns on postoperative new-onset atrial fibrillation in cardiopulmonary bypass surgery

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Critical Care200812 (Suppl 2) :P251

https://doi.org/10.1186/cc6472

  • Published:

Keywords

  • Atrial Fibrillation
  • Cardiopulmonary Bypass
  • Left Atrium
  • Tissue Doppler Imaging
  • Mitral Annulus

Introduction

Postoperative atrial fibrillation is one of the most frequent complications after cardiopulmonary bypass (CPB) surgery. We evaluated the value of preoperative transthoracic echocardiography and tissue Doppler imaging (TDI) analysis of the mitral annulus and the incidence of postoperative new-onset atrial fibrillation (NOAF) in CPB surgery.

Methods

A cohort of CPB surgery patients underwent a preoperative transthoracic echocardiography. The annular TDI waveforms were obtained from the apical four-chamber view. The sample volume was located at the septal and lateral side of the mitral annulus. Early (E') and late (A') diastolic mitral annulus velocities and the ratio of early to late peak velocities (E'/A') were obtained. SPSS version 15 was used.

Results

We studied 166 patients, 50 (30.1%) women and 116 (69.9%) men, mean age 67 ± 1 years. Surgical procedures were 92 (55.4%) coronary artery bypass grafting, 55 (33.1%) valvular, 16 (9.5%) combined surgery and three (1.8%) other procedures. Postoperative NOAF developed in 37 (74%) patients out of 50 patients with postoperative atrial fibrillation. There were no differences in preoperative left ventricular function between groups. We found a higher distance of the left atrium in systole and diastole in patients with NOAF (P = 0.005 and P = 0.038, respectively) and a higher D pulmonary vein peak velocity (52 ± 18 cm/s versus 41 ± 14 cm/s, P = 0.02). Patients with NOAF had a higher TDI E/A septal ratio (0.90 ± 0.33 versus 0.74 ± 0.29, P = 0.22). Attending to preoperative diastolic filling patterns, patients with NOAF had nine (24.3%) normal pattern, 19 (51.3%) abnormal relaxation, eight (21.6%) pseudonormal pattern and one (2.7%) restrictive pattern (P = 0.11), but NOAF patients were prompted to have an alteration in the diastolic filling pattern (28 (75.7%) versus 9 (24.3%), P = 0.028).

Conclusion

Higher size of the left atrium, preoperative D pulmonary vein peak velocity and TDI E/A ratio together with any degree of alteration of preoperative diastolic filling pattern were associated with postoperative NOAF in CPB surgery.

Authors’ Affiliations

(1)
Hospital Universitario de Canarias, La Laguna, Tenerife, Spain

Copyright

© BioMed Central Ltd 2008

This article is published under license to BioMed Central Ltd.

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