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Early diastolic strain rate in relation to long term prognosis following isolated coronary artery bypass grafting

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  • Mats C.H. Lassen
  • Søren Lindberg
  • Flemming J. Olsen
  • Thomas Fritz-Hansen
  • Sune Pedersen
  • Allan Iversen
  • Søren Galatius
  • Rasmus Møgelvang
  • Tor Biering-Sørensen
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Background: The ratio of early mitral inflow velocity to early diastolic strain rate (E/e'sr) is a novel echocardiographic measure to estimate early left ventricular (LV) filling pressure. We hypothesize that E/e'sr is a predictor of outcome following coronary artery bypass grafting (CABG) and that it is superior to the conventionally used E/e'. Methods & results: Consecutive patients undergoing isolated CABG at Gentofte Hospital (n = 652) were included. The mean age of the study population was 67 ± 9 years, 84% were male, mean LVEF was 50 ± 11%. Prior to surgery, all patients underwent an extensive echocardiographic examination. The outcome was all-cause mortality. During follow-up (median 3.8 years [IQR: 2.7; 4.9 years]), a total of 73 (11.2%) died. Both E/e' and E/e'sr were significant predictors in univariable models. In a multivariable model, E/e'sr remained an independent predictor of outcome (HR:1.05 [1.01–1.10], p = 0.049, per 10 cm increase) whereas E/e' did not (HR:1.05 [0.99–1.11], p = 0.053, per 1-unit increase). The relationship between E/e'sr, and the outcome was significantly modified by GLS (p for interaction = 0.043). In the multivariable model, E/e'sr was still significantly associated with the outcome in patients with high GLS (≥13.6%) (HR:1.18 [1.02–1.36], p = 0.029) but not in patients with low GLS (HR 1.04 CI95%: [0.99–1.10], p = 0.14). E/e' was not a significant predictor of all-cause mortality after multivariable adjustment in neither of the groups. E/e'sr improved net reclassification with 33% when added to EuroSCOREII. Conclusion: Following CABG, preoperative E/e'sr is an independent predictor of all-cause mortality, especially in patients with preserved systolic function and superior to E/e'.

TidsskriftInternational Journal of Cardiology
Sider (fra-til)137-142
Antal sider6
StatusUdgivet - 15 dec. 2021

Bibliografisk note

Funding Information:
TBS reports being a Steering Committee member of the Amgen financed GALACTIC-HF trial, received research grants from Sanofi Pasteur and GE healthcare, on the advisory board for Sanofi Pasteur and Amgen, and speaker honorariums from Novartis and Sanofi Pasteur.

Funding Information:
MHL received a research grant from Herlev & Gentofte University Hospital's Internal Research Funds . FJO received financial support from the Danish Heart Foundation . TBS received financial support from Fondsbørsvekselerer Henry Hansen og Hustrus Hovedlegat , Herlev and Gentofte Hospital , the Lundbeck Foundation and the Novo Nordisk Foundation .

Publisher Copyright:
© 2021 The Authors

ID: 69366086