Preoperative echocardiographic indices of diastolic dysfunction and brain natriuretic peptide in predicting postoperative atrial fibrillation after noncardiac surgery Journal Article

  


Authors: Brecher, O.; Gulati, H.; Roistacher, N.; Zhang, H.; Shi, W.; Thaler, H. T.; Amar, D.
Article Title: Preoperative echocardiographic indices of diastolic dysfunction and brain natriuretic peptide in predicting postoperative atrial fibrillation after noncardiac surgery
Abstract: Background: We have shown previously that either echocardiographic indices of diastolic dysfunction or increased preoperative brain natriuretic peptide (BNP) predict postoperative atrial fibrillation (POAF). Because these 2 predictors of POAF have not been evaluated together, our goal was to further elucidate their concurrent role in patients undergoing noncardiac thoracic surgery. Methods: We retrospectively identified 191 patients who had a preoperative transthoracic echocardiogram and serum BNP level collected as part of routine care before major lung or esophageal resection. Clinical and echocardiographic data were compared between patients who did or did not develop POAF (>5 minutes), and prognostic factors for POAF were identified. Results: Univariate associations with POAF (41 of 191; 22% patients) included older age (P = .04), male sex (P = .01), hypertension (P = .03), increased body mass index (P = .01), and prolonged transmitral flow deceleration time (P < .0001), whereas BNP was not statistically significant (P = .07). Stepwise logistic regression analysis showed that both increasing transmitral flow deceleration time (continuous data log base 2 transformed; odds ratio, 16.05; 95% confidence interval, 3.74-68.96; P = .0002) and left atrial diastolic volume index (continuous data log base 2 transformed; odds ratio, 3.29; 95% confidence interval, 1.22-8.91; P = .02) were independent risk factors of POAF (area under the receiver operating characteristic curve = 0.73). There was no significant interaction between BNP and the 2 independent variables (P = .60, and P = .90), respectively. Conclusions: In a cohort of patients who had echocardiography and BNP measurements before undergoing major thoracic surgery, this study showed that when evaluated together greater preoperative left atrial diastolic volume index and transmitral flow deceleration time but not BNP levels were independent predictors for POAF. Copyright © 2017 International Anesthesia Research Society.
Journal Title: Anesthesia and Analgesia
Volume: 124
Issue: 4
ISSN: 0003-2999
Publisher: Lippincott Williams & Wilkins  
Date Published: 2017-04-01
Start Page: 1099
End Page: 1104
Language: English
DOI: 10.1213/ane.0000000000001471
PROVIDER: scopus
PUBMED: 27918330
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85002214694&doi=10.1213%2fANE.0000000000001471&partnerID=40&md5=5dd930cd31331c777306793b74dc0640
Notes: Article -- Export Date: 2 May 2017 -- Source: Scopus
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MSK Authors
  1. Nancy Roistacher
    38 Roistacher
  2. Weiji Shi
    121 Shi
  3. David Amar
    137 Amar
  4. Howard T Thaler
    245 Thaler
  5. Hao Zhang
    62 Zhang
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