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Table 3 Distribution of perioperative variables according to the presence of post-CPB left ventricular dysfunction

From: Preoperative diastolic function predicts the onset of left ventricular dysfunction following aortic valve replacement in high-risk patients with aortic stenosis

 

No LV dysfunction (n = 56)

With LV dysfunction (n = 38)

P value

Preoperative clinical and biological variables

Age (y)

66 (9)

74 (10)

0.004

Male Gender (%)

61.8

66.7

0.288

Body Mass Index (kg/m 2 )

28 (5)

27 (6)

0.281

Hypertension (%)

85.1

82.3

0.654

Diabetes Mellitus (%)

30.9

27.5

0.745

Coronary Artery Disease (%)

29.1

38.5

0.412

Peripheral Vascular Disease (%)

12.1

10.9

0.511

Dyslipemia (%)

71.8

54.5

0.098

Renal Insufficiency 1 (%)

3.6

5.2

0.532

Anemia 2 (%)

7.1

10.1

0.789

Beta-blockers (%)

49.1

61.5

0.295

ACE Inhibitors or AII antagonists (%)

20.1

35.9

0.352

Calcium channel antagonists (%)

23.6

33.3

0.101

Diuretics (%)

21.9

17.9

0.796

Nitrate (%)

12.7

17.9

0.562

LV Ejection Fraction (%)

56 (8)

49 (11)

0.001

Parsonnet score (u)

15 (9)

21 (9)

0.001

Intraoperative echocardiographic data

   

LV Mass Index (g/m 2 )

135 (34)

140 (29)

0.188

LV Fractional Area Changes (%)

54 (14)

46 (14)

0.015

LV Septal Thickness (mm)

16 (3)

17 (4)

0.899

Transmitral E/A ratio

1.2 (0.6)

1.3 (0.7)

0.415

Deceleration Time (ms)

181 (81)

158 (65)

0.173

Isovolemic Relaxation Time (ms)

108 (30)

106 (32)

0.897

PV S/D ratio

1.2 (0.4)

1.1 (0.5)

0.067

PV Ar (ms)

14 (9)

16 (7)

0.198

E'/A' lateral

1.0 (0.5)

0.9 (0.5)

0.736

E'/A' septal

1.0 (0.4)

1.0 (0.6)

0.716

Vp (cm/s)

53 (11)

37 (7)

<0.001

Diastolic Functional Class

  

<0.001

   Normal (%)

26.8

0

 

   Impaired Relaxation (%)

50.0

34.2

 

   Pseudo-normalization (%)

23.2

42.1

 

   Restrictive pattern (%)

0.0

23.7

 

Surgical variables

11

16

 

Type of Procedure (%)

  

0.280

   Isolated Valve Replacement

65.9

51.1

 

   Associated Coronary Artery Bypass

21.6

34.1

 

   Associated Aortic Root Replacement

12.5

14.8

 

Aortic Clamping Time (minutes)

77 (28)

98 (40)

0.010

Cardiopulmonary Bypass Time (minutes)

101 (33)

135 (57)

0.004

Indexed Effective Orifice Area

1.05 (0.11)

0.98 (0.13)

0.634

  1. LV, left ventricular; CPB, cardiopulmonary bypass.
  2. *P < 0.05, between the two groups; χ2 test with Yates correction or unpaired Student t test.
  3. LV, left ventricule; ACE, angiotensin converting enzyme; AII, angiotensin II; PV Ar, pulmonary vein atrial reversal velocity; PV S/D, ratio of peak systolic to diastolic pulmonary vein flow velocities; E'/A', ratio of early to late diastolic velocities of the mitral annulus determined by tissue Doppler imaging.
  4. 1Renal insufficency defined as creatinine clearance <10 ml/minute.
  5. 2Anemia defined as Hemoglobin <110 g/L in female and <120 g/L in male.
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