Bing Tang1,2, Yunhu Song2, Sainan Cheng3, Hao Cui2, Keshan Ji3, Shihua Zhao3, Shuiyun Wang2. 1. Department of Cardiovascular Surgery, Beijing Aortic Disease Center, Beijing Institute of Heart, Lung and Blood Vessel Diseases & Beijing Anzhen Hospital, Capital Medical University, Beijing, China. 2. Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. 3. Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Abstract
OBJECTIVES: This study aims to investigate the risk factors of in-hospital postoperative atrial fibrillation (POAF) and the impact of POAF on the clinical outcome in hypertrophic cardiomyopathy (HCM) patients who underwent myectomy. METHODS: Data from a total of 494 obstructive HCM patients, who had undergone preoperative cardiac magnetic resonance (CMR) testing and who underwent myectomy at Fuwai Hospital from June 2011 to June 2016, were collected. RESULTS: Multivariate logistic regression analysis showed that old age (odds ratio [OR], 4.326; 95% confidence interval [CI], 2.248-8.325; p <0.001), maximal left atrium volume (LAV) (OR, 1.137; 95% CI, 1.075-1.202; p <0.001), and hypertension (OR, 2.754; 95% CI, 1.262-6.007; p = 0.011) were associated with the incidence of POAF. In the patients without preoperative AF, Cox regression analysis demonstrated that POAF (p = 0.002), decreased left atrium (LA) ejection fraction (LAEF) (p = 0.036), concomitant procedure (p = 0.039), and postoperative residual moderate or severe mitral valve regurgitation (p = 0.030) were independent predictors of composite cardiovascular events. CONCLUSIONS: POAF indicated a poorer clinical outcome after myectomy for obstructive HCM patients, which was similar to those with preoperative AF. Elevated LAV was independently related to POAF onset in HCM patients who underwent myectomy.
OBJECTIVES: This study aims to investigate the risk factors of in-hospital postoperative atrial fibrillation (POAF) and the impact of POAF on the clinical outcome in hypertrophic cardiomyopathy (HCM) patients who underwent myectomy. METHODS: Data from a total of 494 obstructive HCMpatients, who had undergone preoperative cardiac magnetic resonance (CMR) testing and who underwent myectomy at Fuwai Hospital from June 2011 to June 2016, were collected. RESULTS: Multivariate logistic regression analysis showed that old age (odds ratio [OR], 4.326; 95% confidence interval [CI], 2.248-8.325; p <0.001), maximal left atrium volume (LAV) (OR, 1.137; 95% CI, 1.075-1.202; p <0.001), and hypertension (OR, 2.754; 95% CI, 1.262-6.007; p = 0.011) were associated with the incidence of POAF. In the patients without preoperative AF, Cox regression analysis demonstrated that POAF (p = 0.002), decreased left atrium (LA) ejection fraction (LAEF) (p = 0.036), concomitant procedure (p = 0.039), and postoperative residual moderate or severe mitral valve regurgitation (p = 0.030) were independent predictors of composite cardiovascular events. CONCLUSIONS:POAF indicated a poorer clinical outcome after myectomy for obstructive HCMpatients, which was similar to those with preoperative AF. Elevated LAV was independently related to POAF onset in HCMpatients who underwent myectomy.