Báo cáo y học: "Preoperative diastolic function predicts the onset of left ventricular dysfunction following aortic valve replacement in high-risk patients with aortic stenosis" docx

Licker et al Critical Care 2010, 14:R101 http://ccforum.com/content/14/3/R101 Open Access RESEARCH Preoperative diastolic function predicts the onset of left ventricular dysfunction following aortic valve replacement in high-risk patients with aortic stenosis Research Marc Licker*1, Mustafa Cikirikcioglu2, Cidgem Inan1, Vanessa Cartier1, Afksendyios Kalangos2, Thomas Theologou2, Tiziano Cassina3 and John Diaper1 Abstract Introduction: Left ventricular (LV) dysfunction frequently occurs after cardiac surgery, requiring inotropic treatment and/or mechanical circulatory support In this study, we aimed to identify clinical, surgical and echocardiographic factors that are associated with LV dysfunction during weaning from cardiopulmonary bypass (CPB) in high-risk patients undergoing valve replacement for aortic stenosis Methods: Perioperative data were prospectively collected in 108 surgical candidates with an expected operative mortality ≥9% All anesthetic and surgical techniques were standardized Reduced LV systolic function was defined by an ejection fraction 0.25 mcg/kg/min, norepinephrine >0.02 mcg/kg/min) in the presence of low MAP ( 200 ms, IVRT ≥ 100 ms and E'/A' 1.5), pseudo-normalization (E/A = to 2, DT = 150 to 200 ms, and E'/A'