preoperative diastolic function predicts the onset of left ventricular dysfunction following aortic valve replacement in high-risk patients with aortic stenosis术前舒张功能预测主动脉瓣置换术后左心室功能障碍的发病在高危患者主动脉瓣狭窄.pdfVIP

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preoperative diastolic function predicts the onset of left ventricular dysfunction following aortic valve replacement in high-risk patients with aortic stenosis术前舒张功能预测主动脉瓣置换术后左心室功能障碍的发病在高危患者主动脉瓣狭窄.pdf

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preoperative diastolic function predicts the onset of left ventricular dysfunction following aortic valve replacement in high-risk patients with aortic stenosis术前舒张功能预测主动脉瓣置换术后左心室功能障碍的发病在高危患者主动脉瓣狭窄

Licker et al. Critical Care 2010, 14:R101 /content/14/3/R101 R E S E A R C H Open Access Research Preoperative diastolic function predicts the onset of left ventricular dysfunction following aortic valve replacement in high-risk patients with aortic stenosis 1 2 1 1 2 2 Marc Licker* , Mustafa Cikirikcioglu , Cidgem Inan , Vanessa Cartier , Afksendyios Kalangos , Thomas Theologou , Tiziano Cassina3 and John Diaper 1 Abstract Introduction: Left 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. Methods: Perioperative data were prospectively collected in 108 surgical candidates with an expected operative mortality ≥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). Results: Doppler-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 dysfuncti