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首页> 外文期刊>European heart journal cardiovascular Imaging >Incremental value of global longitudinal strain for predicting early outcome after cardiac surgery
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Incremental value of global longitudinal strain for predicting early outcome after cardiac surgery

机译：总纵向应变对预测心脏手术后早期结果的增量值

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Aims: Global longitudinal strain (GLS) seems accurate for detecting subclinical myocardial dysfunction, and may therefore be used to improve risk stratification for cardiac surgery. Methods and results: Longitudinal strain (by two-dimensional speckle tracking) was computed in 425 patients [mean age 67 ± 13 years, 69% male, left ventricular ejection fraction (LVEF) 51 ± 13%] referred for cardiac surgery [isolated coronary artery bypass graft (CABG) (n = 155), aortic valve surgery (n = 174), mitral surgery (n = 96)]. GLS (global-ε) was assessed for predicting early postoperative death. Despite a fair correlation between LVEF and global strain (r = -0.73, P < 0.0001), 40% of patients with preserved LVEF (defined as LVEF ≥50%) had abnormal global-ε (defined as global-ε >-16%): -12.8 ± 1.7%, range -15% to -8%. In patients with preserved LVEF, NT-proBNP level (983 vs. 541 pg/mL, P = 0.03), heart failure symptoms (NYHA class, 2.2 ± 0.9 vs. 1.9 ± 0.9, P = 0.02), and the need for prolonged (>48 h) inotropic support after surgery (33.3 vs. 21.2%, P = 0.03) were greater when global-ε was impaired. Importantly, despite similar EuroSCORE (9.7 ± 12 vs. 7.7 ± 9%, P = 0.2 for EuroSCORE I and 4.2 ± 6.2 vs. 3.4 ± 4.9%, P = 0.4 for EuroSCORE II), the rate of postoperative death was 2.4-fold (11.8 vs. 4.9%, P = 0.04) in patients with preserved LVEF when global-ε was impaired. Multivariate analysis showed that global-ε is an independent predictor for early postoperative mortality [odds ratio = 1.10 (1.01-1.21)] after adjustment to EuroSCORE. Conclusion: GLS has an incremental value over LVEF for risk stratification in patients referred for cardiac surgery. All rights reserved.
机译：目的：整体纵向应变（GLS）似乎可以准确地检测亚临床心肌功能障碍，因此可用于改善心脏手术的危险分层。方法和结果：425例[平均年龄67±13岁，男性69％，左心室射血分数（LVEF）51±13％]被推荐用于心脏手术[孤立的冠状动脉]，计算纵向应变（通过二维斑点追踪）动脉搭桥术（CABG）（n = 155），主动脉瓣手术（n = 174），二尖瓣手术（n = 96）]。对GLS（global-ε）进行了评估，以预测术后早期死亡。尽管LVEF与总体应变之间存在明显的相关性（r = -0.73，P <0.0001），但40％LVEF保留患者（定义为LVEF≥50％）的总体ε异常（定义为全局ε> -16％） ）：-12.8±1.7％，范围为-15％至-8％。 LVEF，NT-proBNP水平保持不变的患者（983 vs. 541 pg / mL，P = 0.03），心力衰竭症状（NYHA级，2.2±0.9 vs. 1.9±0.9，P = 0.02），需要延长治疗时间整体ε受损时（> 48 h）术后的正性肌力支持率（33.3 vs. 21.2％，P = 0.03）更大。重要的是，尽管有类似的EuroSCORE（EuroSCORE I为9.7±12对7.7±9％，P = 0.2，EuroSCORE II为4.2±6.2对3.4±4.9％，P = 0.4），但术后死亡率为2.4倍整体ε受损时，LVEF保留的患者（11.8 vs. 4.9％，P = 0.04）。多因素分析表明，在调整为EuroSCORE后，global-ε是术后早期死亡率的独立预测因子[几率= 1.10（1.01-1.21）]。结论：对于进行心脏手术的患者，GLS在风险分层方面的价值高于LVEF。版权所有。

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