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首页> 外文期刊>Circulation journal >Association of carotid arterial circumferential strain with left ventricular function and hemodynamic compromise during off-pump coronary artery bypass surgery
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Association of carotid arterial circumferential strain with left ventricular function and hemodynamic compromise during off-pump coronary artery bypass surgery

机译：体外循环冠状动脉搭桥手术中颈动脉周围应变与左心室功能和血流动力学损害的关系

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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.
机译：背景：考虑到心室-血管耦合的重要性，动脉僵硬度的量度可能反映了整体心肌的功能。我们评估了超声散斑跟踪测量的颈总动脉外周应变（CCA CirS）对非体外循环冠状动脉搭桥术（OPCAB）期间血流动力学恶化的预测价值，并评估了其与心肌功能超声心动图指标的关联。入选左室射血分数（LVEF）≥50％的患者。比较了术中血流动力学变量与CCA CirS三分位数的相关性。总共分析了96例患者。左旋支气管移植和胸骨闭合期间的混合静脉血氧饱和度（SvO2）在第一三分位数中低于第三三分位数。在单因素logistic回归女性中，早期传播速度与环形速度，脉压和CCA CirS的比率是血液动力学恶化的指标（定义为SvO2降低≥20％），而多因素分析后仅CCA CirS仍然是独立的预测指标（OR，0.27; 95％CI：0.11-0.68）。 CCA CirS曲线下的预测面积为0.730（95％CI：0.608-0.852）。结论：CCA CirS是反映LV功能的综合标志物，是LVEF保留患者OPCAB期间血液动力学恶化的预测指标。CCA CirS与组织多普勒衍生的LV功能参数密切相关。

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