Perioperative LV strain (AVGGLS) alteration and predictive value for long term occurence of MACE

Abstract

Introduction Preoperative alteration of 2D LV strain (AvgGLS) are associated with LCOS and poor outcome (1-3).There is no report to date investigating the association of low AvgGLS and long term MACE occurrence. Methods AvgGLS was measured by TEE before and post-CPB (GE Vivid S7). We recorded comorbidities, early postoperative complications and survival. MACE were defined as myocardial infarction, atrial fibrillation, ventricular arrhythmias, congestive heart failure, cardiac rehospitalization.Groups were compared whether the AvgGLS was decreased (DEC) or unaltered (UNCH) with a threshold of +10%. Student t and KHI2 tests were used (p Results 158 patients were included. Follow-up was 286+/-115 days (max: 20-520). 45.5% patients had CABG, 35.2% valvular surgery and 19.3% combined surgery. The AvgGLS(%) was -14.38+/-4.19(IC95: -12.96, -14.34) before CPB, vs -10.56+/-4.9(IC95: -9.75, -11.37) after CPB(p Discussion Our main findings are: Almost 70% of patients decrease the AvgGLS after CPB irrespective of type of surgery. these patients experienced significantly more in-hospital complications and ealier incidence of MACE during long term follow-up. Perioperative AvgGLS show very high predictive Se and Sp for MACE occurrence. This opens the possibility of building a predictive score to detect the patients at risk of MACE.