Development of Diastolic Dysfunction in the Postoperative Period in Patients with Acquired Heart Diseases
- #CI/INT 01-O-1
- Cardiology and Imaging in Cardiac Surgery/Intraoperative and Early Assessment of the Results of Surgery. SESSION-1
- Oral
Development of Diastolic Dysfunction in the Postoperative Period in Patients with Acquired Heart Diseases
Irina Averina, Olga Bockeria, Marina Mironenko
A.N.Bakulev National Medical Research Center for Cardiovascular Surgery MoH RF, Moscow, Russia
Date, time and location: 2018.05.27 08:30, Congress Hall, 2F–A
Abstract
Objective:
Assessment of development of diastolic dysfunction (DD) in patients with acquired heart diseases in the postoperative period
Materials and Methods:
34 patients with aortic regurgitation/stenosis, mitral regurgitation, normal systolic and diastolic function before surgery were included. The median age was 46,7 years. Patients examined 8-14 days and 12-36 months after the surgery. Echocardiography, tissue doppler and speckle tracking analysis were performed. To assess the grade of LV fibrosis contrast MRI was used. Group 0 - patients with normal diastolic function after surgery, group 1 - evolved grade I, II, III DD, group A- no fibrosis and B-with fibrosis. Septal velocity es < 7 cm/sec, lateral eL < 10 cm/sec, average E/e ratio > 14, left atrial (LA) volume index > 34 mL/m2, and peak tricuspid regurgitation (TR) velocity> 2.8 m/sec andЕ/A have been used to identify left ventricular (LV) DD.
Results
LV DD occurred in 9 (26.5%) patients after surgery. The appearance of LV DD was associated with an immediate post-surgical and subsequent progressive long-term decrease of the septal es from 8.5 ± 0.71 to 4.6 ± 0.53 cm/sec (p = 0.005) and the presence of fibrosis (r-0.663, p = 0.001). In the group B without fibrosis transient post-surgical decrease in lateral eL from 10.2 ± 3.1 to 7.5 ± 2.43 cm/sec (p = 0.035) was observed with the returning to the normal value at long-term period. There were no correlations between LV DD and arrhythmias, LVEF, LV volumes. Fibrosis was mostly apparent at the junction of the septum with LV and RV free walls.
Conclusions
The worsening of diastolic function in patients with aortic regurgitation/stenosis and mitral regurgitation correlated with fibrosis and was due to damage of the septum function immediately after surgeryand in long-term.