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Predictors and Clinical Impacts of Aggravated Left Ventricular Diastolic Dysfunction After Off-Pump Coronary Artery Bypass Grafting

Authors
 Seung Hyun Lee  ;  Kwan Wook Kim  ;  Hyun-Chel Joo  ;  Kyung-Jong Yoo  ;  Young-Nam Youn 
Citation
 Circulation Journal, Vol.80(9) : 1937-1945, 2016 
Journal Title
 Circulation Journal 
ISSN
 1346-9843 
Issue Date
2016
MeSH
Aged ; Coronary Artery Bypass, Off-Pump/adverse effects* ; Disease-Free Survival ; Female ; Humans ; Male ; Middle Aged ; Survival Rate ; Ventricular Dysfunction, Left*/etiology ; Ventricular Dysfunction, Left*/mortality ; Ventricular Dysfunction, Left*/physiopathology
Keywords
Diastolic heart failure ; Doppler echocardiography ; Off-pump coronary artery bypass ; Peripheral arterial disease ; Renal insufficiency
Abstract
BACKGROUND: To determine the predictors of aggravated left ventricular diastolic dysfunction (LVDD) in patients undergoing off-pump coronary artery bypass grafting (OPCAB) and to compare late outcomes according to the aggravated LVDD. METHODS?AND?RESULTS: OPCAB was performed in 1,101 patients (2001-2013). LVDD was classified as normal, mild, moderate or severe. Patients were divided into 2 groups: non-aggravated LVDD (group I) and aggravated LVDD (group II). The primary endpoint was aggravation of LVDD. The secondary endpoint was late mortality and morbidity such as major adverse cardiac and cerebrovascular events (MACCE) related to LVDD aggravation postoperatively. There were 894 patients in group I and 207 in group II. Multivariate analysis revealed that preoperative peripheral artery obstructive disease (PAOD) (P=0.04), renal failure (P<0.01), and A' velocity (P<0.01) anticipated aggravated LVDD. The Cox hazards model revealed that aggravated LVDD was a poor prognostic factor for MACCE (P<0.01) and overall survival (P<0.01). The Kaplan-Meier survival curve showed that aggravated LVDD was related to poor late outcomes (freedom from MACCE, P=0.01; overall survival, P<0.01). CONCLUSIONS: Aggravated LVDD significantly affects late clinical outcomes after OPCAB and preoperative PAOD, renal failure, and A' velocity might be predictors.
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DOI
10.1253/circj.CJ-16-0165
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Yoo, Kyung Jong(유경종) ORCID logo https://orcid.org/0000-0002-9858-140X
Youn, Young Nam(윤영남)
Lee, Seung Hyun(이승현) ORCID logo https://orcid.org/0000-0002-0311-6565
Joo, Hyun Chel(주현철) ORCID logo https://orcid.org/0000-0002-6842-2942
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/152020
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