Association of Carotid Arterial Circumferential Strain With Left Ventricular Function and Hemodynamic Compromise During Off-Pump Coronary Artery Bypass Surgery
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概要
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Background:Considering the importance of ventricular-vascular coupling, a measure of arterial stiffness may reflect global myocardial performance. We evaluated the predictive value of common carotid arterial circumferential strain (CCA CirS), measured with ultrasound speckle tracking, for hemodynamic deterioration during off-pump coronary artery bypass (OPCAB) and assessed its association with echocardiographic indices of myocardial function.Methods and Results:Patients with left ventricular ejection fraction (LVEF) ≥50% were enrolled. Intraoperative hemodynamic variables were compared in relation to CCA CirS tertiles. A total of 96 patients were analyzed. Mixed venous oxygen saturation (SvO2) during left circumflex artery grafting and sternum closure were lower in the first tertile than in the third tertile. On univariate logistic regression female gender, ratio of early transmitral velocity to annular velocity, pulse pressure, and CCA CirS were predictors of hemodynamic deterioration (defined as decrease in SvO2≥20%), while only CCA CirS remained as an independent predictor after multivariate analysis (OR, 0.27; 95% CI: 0.11–0.68). Area under the curve of CCA CirS for its prediction was 0.730 (95% CI: 0.608–0.852). CCA CirS was strongly associated with tissue Doppler-derived parameters of LV function.Conclusions:CCA CirS is a comprehensive marker reflecting LV function, and a predictor for hemodynamic deterioration during OPCAB in patients with preserved LVEF. (Circ J 2014; 78: 2422–2430)
- 一般社団法人 日本循環器学会の論文
著者
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Kwak Young-Lan
Department of Anesthesia and Pain Medicine, Yonsei Cardiovascular Center, Yonsei University College
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Song Young
Department Of Animal Resources Technology Jinju National University
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Shim Chi-young
Division Of Cardiology Yonsei University College Of Medicine Yonsei University Health System
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Kim Eui-Kyung
Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine
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Kwak Young-Lan
Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine
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Shim Jae-Kwang
Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine
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Song Jong-Wook
Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine
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