Key result
Preoperative global longitudinal strain and diastolic dysfunction parameters significantly predicted worse early outcomes after coronary artery bypass grafting, including prolonged intubation time and greater inotrope requirements.
Why the study?
Myocardial longitudinal strain echocardiography may assess ventricular function more accurately than LVEF, prompting investigation into whether speckle tracking strain and echocardiographic parameters can predict early and long-term outcomes after CABG.
Do preoperative global longitudinal strain and diastolic dysfunction parameters predict early and long-term clinical outcomes in patients undergoing elective CABG?
Observational (n=69)
No
Do preoperative global longitudinal strain and diastolic dysfunction parameters predict early and long-term clinical outcomes in patients undergoing elective CABG?
Effect estimate: AUC 0.653
p-value: p=0.038
Preoperative global longitudinal strain and diastolic dysfunction parameters are useful predictors of early adverse clinical outcomes, such as prolonged intubation and increased inotrope requirements, following elective CABG.
May aid preoperative risk stratification in elective CABG; leaves open added value beyond standard scores and long-term outcome prediction.
BACKGROUND: Coronary artery bypass graft (CABG) surgery is an effective therapeutic strategy for coronary heart disease (CHD). Myocardial longitudinal strain echocardiography with 2D speckle tracking could obtain ventricular function with better accuracy and reliability than the left ventricular ejection fraction. The aim of the study was to assess changes in left ventricular function in patients before and after surgical revascularization for a 24-month period of observation, using echocardiography with speckle tracking strain imaging. We searched for echocardiographic predictors of poor early and long-term outcome after CABG. METHODS: We enrolled 69 patients scheduled for elective coronary bypass grafting. Patients were divided into groups based on pre-operative systolic and diastolic parameters, depending on the GLS value and the E' Lat and E/E' value. The correlation between these parameters and early and long-term outcomes was analyzed. RESULTS: Preoperative EF was preserved in 86, 95% (60) patients. Pre-operative reduced GLS was observed in 73.91% (51) of patients and severely reduced in 31.88% (22). In the first post-operative 6-month period, we observed a significant decrease in the GLS. The GLS was a predictor of early postoperative outcome for intubation time, the inotropes use and length of ICU stay. Diastolic dysfunction was a predictor of the greater inotrope requirements. CONCLUSIONS: Global longitudinal strain and diastolic dysfunction parameters are a good predictors of worse early outcome after CABG.
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Goździk et al. (2019) conducted an observational in Coronary heart disease (n=69). Preoperative global longitudinal strain (GLS) and diastolic dysfunction vs. Normal GLS and diastolic function was evaluated on Greater requirements for inotrope use (predicted by preoperative GLS) (AUC 0.653, p=0.038). Preoperative global longitudinal strain and diastolic dysfunction parameters significantly predicted worse early outcomes after coronary artery bypass grafting, including prolonged intubation time and greater inotrope requirements.
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