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Plasma big endothelin-1 predicts new-onset atrial fibrillation after surgical septal myectomy in patients with hypertrophic cardiomyopathy
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Plasma big endothelin-1 predicts new-onset atrial fibrillation after surgical septal myectomy in patients with hypertrophic cardiomyopathy
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Plasma big endothelin-1 predicts new-onset atrial fibrillation after surgical septal myectomy in patients with hypertrophic cardiomyopathy
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Journal Article
Plasma big endothelin-1 predicts new-onset atrial fibrillation after surgical septal myectomy in patients with hypertrophic cardiomyopathy
2019
Overview
Background
Postoperative atrial fibrillation (POAF) is a common complication in patients with obstructive hypertrophic cardiomyopathy (HOCM) who undergo surgical myectomy. POAF is associated with poor outcome. The role of plasma big endothelin-1 level in predicting atrial fibrillation after surgical septal myectomy in HOCM patients has not well been studied.
Methods
A total of 118 patients with HOCM who underwent surgical septal myectomy were recruited in this study. Plasma big endothelin-1 level was measured. The heart rhythm was continuously monitored during hospital stay. Preoperative, intraoperative, and postoperative variables were collected.
Results
POAF developed among 26 of the 118 patients (22%) in this study. Compared with those without POAF, patients with POAF were significantly older (53.5 ± 10.6 vs. 47.3 ± 13.6 years,
P
= 0.033), more likely to undergo mitral valve surgery (38.5% vs. 18.5%,
P
= 0.032), and had higher plasma big endothelin-1 levels (0.41 ± 0.19 vs. 0.27 ± 0.14 pmol/l,
P
= 0.001), longer hospital stay (9.1 ± 3.7 vs. 7.5 ± 2.8 days,
P
= 0.022), larger preoperative left atria (48.0 ± 5.2 vs. 44.1 ± 5.9 mm;
P
= 0.003). In the receiver operating characteristic curve analysis, the area under the curve for big endothelin-1 was 0.734 (95% CI, 0.634 to 0.834, P<0.001). In multivariate logistic regression analysis, preoperative big endothelin-1 level (OR 100.7, 95%CI: 5.0–2020.0,
P
= 0.003) and left atrial diameter (OR 1.106, 95%CI: 1.015–1.205,
P
= 0.022) were independent predictors of POAF.
Conclusion
Elevated preoperative plasma big endothelin-1 level is an independent predictor of POAF in HOCM patients undergoing surgical septal myectomy.
Publisher
BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
Subject
/ Aged
/ Atrial Fibrillation - diagnosis
/ Atrial Fibrillation - etiology
/ Atrial Fibrillation - physiopathology
/ Cardiac Surgical Procedures - adverse effects
/ Cardiomyopathy, Hypertrophic - blood
/ Cardiomyopathy, Hypertrophic - diagnosis
/ Cardiomyopathy, Hypertrophic - surgery
/ Complications and side effects
/ Female
/ Humans
/ Male
/ Medicine
/ Non-coronary artery cardiac disease
/ Patient monitoring equipment
/ Patients
/ Plasma
/ Postoperative atrial fibrillation
/ Surgery
