Increased Aortic Stiffness Can Predict Perioperative Cardiovascular Outcomes in Patients Undergoing Noncardiac, Nonvascular Surgery
Background Aortic stiffness is an early marker of arteriosclerosis and associated with cardiovascular mortality. However, the impact of aortic stiffness on perioperative cardiovascular outcomes in patients undergoing noncardiac surgery is unknown. Methods The study population was composed of 660 con...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Biteker, Murat [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2011 |
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| Schlagwörter: |
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| Anmerkung: |
© Société Internationale de Chirurgie 2011 |
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| Übergeordnetes Werk: |
Enthalten in: World Journal of Surgery - Springer-Verlag, 1996, 35(2011), 11 vom: 09. Sept. |
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| Übergeordnetes Werk: |
volume:35 ; year:2011 ; number:11 ; day:09 ; month:09 |
| Links: |
|---|
| DOI / URN: |
10.1007/s00268-011-1268-3 |
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SPR00343110X |
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| 520 | |a Background Aortic stiffness is an early marker of arteriosclerosis and associated with cardiovascular mortality. However, the impact of aortic stiffness on perioperative cardiovascular outcomes in patients undergoing noncardiac surgery is unknown. Methods The study population was composed of 660 consecutive adults aged 18 years and over (mean age = 65.3 ± 14 years) who underwent intermediate-risk (nonvascular), noncardiac surgery between January 2010 and February 2011. Nonemergency, non-day-case, open surgical procedures were enrolled. Aortic stiffness indices were calculated from the aortic diameters measured by echocardiography. Electrocardiography and cardiac biomarkers were evaluated 1 day before surgery, and on days 1, 3, and 7 after surgery. Results Eighty patients (12.1%) experienced perioperative cardiovascular events (PCE). Preoperative aortic distensibility (AD) (2 ± 1.3 vs. 2.9 ± 1.1 $ cm^{2} $/dyn/$ 10^{3} $, P < 0.001) and aortic strain (AS) (4.4 ± 2.4 vs. 6.4 ± 1.9, P < 0.001) of the patients with PCE were significantly lower than in patients without PCE. Univariate analysis showed a significant association between age, diabetes mellitus (DM), coronary artery disease, preoperative atrial fibrillation, American Society of Anesthesiologists (ASA) status, Revised Cardiac Risk Index, left ventricle ejection fraction (LVEF), AD, aortic strain, and in-hospital PCE. However, on multivariate logistic regression analysis, only AD (OR: 1.94, 95% CI: 1.1–3.4; P = 0.02), AS (OR: 0.45, 95% CI: 0.3–0.6; P < 0.001), DM (OR: 2.28, 95% CI: 1.08–4.82; P = 0.03), and LVEF (OR: 0.96, 95% CI: 0.93–0.99; P = 0.03) remained as significant variables associated with PCE. Conclusion Impaired elastic properties of the aorta are associated with increased PCE rates in patients undergoing noncardiac, nonvascular surgery. | ||
| 650 | 4 | |a Aortic Stiffness |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Leave Ventricle Ejection Fraction |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Aortic Distensibility |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Revise Cardiac Risk Index |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Cardiac Risk Index |7 (dpeaa)DE-He213 | |
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| 700 | 1 | |a Dayan, Akın |4 aut | |
| 700 | 1 | |a İlhan, Erkan |4 aut | |
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10.1007/s00268-011-1268-3 doi (DE-627)SPR00343110X (SPR)s00268-011-1268-3-e DE-627 ger DE-627 rakwb eng Biteker, Murat verfasserin aut Increased Aortic Stiffness Can Predict Perioperative Cardiovascular Outcomes in Patients Undergoing Noncardiac, Nonvascular Surgery 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2011 Background Aortic stiffness is an early marker of arteriosclerosis and associated with cardiovascular mortality. However, the impact of aortic stiffness on perioperative cardiovascular outcomes in patients undergoing noncardiac surgery is unknown. Methods The study population was composed of 660 consecutive adults aged 18 years and over (mean age = 65.3 ± 14 years) who underwent intermediate-risk (nonvascular), noncardiac surgery between January 2010 and February 2011. Nonemergency, non-day-case, open surgical procedures were enrolled. Aortic stiffness indices were calculated from the aortic diameters measured by echocardiography. Electrocardiography and cardiac biomarkers were evaluated 1 day before surgery, and on days 1, 3, and 7 after surgery. Results Eighty patients (12.1%) experienced perioperative cardiovascular events (PCE). Preoperative aortic distensibility (AD) (2 ± 1.3 vs. 2.9 ± 1.1 $ cm^{2} $/dyn/$ 10^{3} $, P < 0.001) and aortic strain (AS) (4.4 ± 2.4 vs. 6.4 ± 1.9, P < 0.001) of the patients with PCE were significantly lower than in patients without PCE. Univariate analysis showed a significant association between age, diabetes mellitus (DM), coronary artery disease, preoperative atrial fibrillation, American Society of Anesthesiologists (ASA) status, Revised Cardiac Risk Index, left ventricle ejection fraction (LVEF), AD, aortic strain, and in-hospital PCE. However, on multivariate logistic regression analysis, only AD (OR: 1.94, 95% CI: 1.1–3.4; P = 0.02), AS (OR: 0.45, 95% CI: 0.3–0.6; P < 0.001), DM (OR: 2.28, 95% CI: 1.08–4.82; P = 0.03), and LVEF (OR: 0.96, 95% CI: 0.93–0.99; P = 0.03) remained as significant variables associated with PCE. Conclusion Impaired elastic properties of the aorta are associated with increased PCE rates in patients undergoing noncardiac, nonvascular surgery. Aortic Stiffness (dpeaa)DE-He213 Leave Ventricle Ejection Fraction (dpeaa)DE-He213 Aortic Distensibility (dpeaa)DE-He213 Revise Cardiac Risk Index (dpeaa)DE-He213 Cardiac Risk Index (dpeaa)DE-He213 Duman, Dursun aut Dayan, Akın aut İlhan, Erkan aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 35(2011), 11 vom: 09. Sept. (DE-627)SPR003391159 nnns volume:35 year:2011 number:11 day:09 month:09 https://dx.doi.org/10.1007/s00268-011-1268-3 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 35 2011 11 09 09 |
| spelling |
10.1007/s00268-011-1268-3 doi (DE-627)SPR00343110X (SPR)s00268-011-1268-3-e DE-627 ger DE-627 rakwb eng Biteker, Murat verfasserin aut Increased Aortic Stiffness Can Predict Perioperative Cardiovascular Outcomes in Patients Undergoing Noncardiac, Nonvascular Surgery 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2011 Background Aortic stiffness is an early marker of arteriosclerosis and associated with cardiovascular mortality. However, the impact of aortic stiffness on perioperative cardiovascular outcomes in patients undergoing noncardiac surgery is unknown. Methods The study population was composed of 660 consecutive adults aged 18 years and over (mean age = 65.3 ± 14 years) who underwent intermediate-risk (nonvascular), noncardiac surgery between January 2010 and February 2011. Nonemergency, non-day-case, open surgical procedures were enrolled. Aortic stiffness indices were calculated from the aortic diameters measured by echocardiography. Electrocardiography and cardiac biomarkers were evaluated 1 day before surgery, and on days 1, 3, and 7 after surgery. Results Eighty patients (12.1%) experienced perioperative cardiovascular events (PCE). Preoperative aortic distensibility (AD) (2 ± 1.3 vs. 2.9 ± 1.1 $ cm^{2} $/dyn/$ 10^{3} $, P < 0.001) and aortic strain (AS) (4.4 ± 2.4 vs. 6.4 ± 1.9, P < 0.001) of the patients with PCE were significantly lower than in patients without PCE. Univariate analysis showed a significant association between age, diabetes mellitus (DM), coronary artery disease, preoperative atrial fibrillation, American Society of Anesthesiologists (ASA) status, Revised Cardiac Risk Index, left ventricle ejection fraction (LVEF), AD, aortic strain, and in-hospital PCE. However, on multivariate logistic regression analysis, only AD (OR: 1.94, 95% CI: 1.1–3.4; P = 0.02), AS (OR: 0.45, 95% CI: 0.3–0.6; P < 0.001), DM (OR: 2.28, 95% CI: 1.08–4.82; P = 0.03), and LVEF (OR: 0.96, 95% CI: 0.93–0.99; P = 0.03) remained as significant variables associated with PCE. Conclusion Impaired elastic properties of the aorta are associated with increased PCE rates in patients undergoing noncardiac, nonvascular surgery. Aortic Stiffness (dpeaa)DE-He213 Leave Ventricle Ejection Fraction (dpeaa)DE-He213 Aortic Distensibility (dpeaa)DE-He213 Revise Cardiac Risk Index (dpeaa)DE-He213 Cardiac Risk Index (dpeaa)DE-He213 Duman, Dursun aut Dayan, Akın aut İlhan, Erkan aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 35(2011), 11 vom: 09. Sept. (DE-627)SPR003391159 nnns volume:35 year:2011 number:11 day:09 month:09 https://dx.doi.org/10.1007/s00268-011-1268-3 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 35 2011 11 09 09 |
| allfields_unstemmed |
10.1007/s00268-011-1268-3 doi (DE-627)SPR00343110X (SPR)s00268-011-1268-3-e DE-627 ger DE-627 rakwb eng Biteker, Murat verfasserin aut Increased Aortic Stiffness Can Predict Perioperative Cardiovascular Outcomes in Patients Undergoing Noncardiac, Nonvascular Surgery 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2011 Background Aortic stiffness is an early marker of arteriosclerosis and associated with cardiovascular mortality. However, the impact of aortic stiffness on perioperative cardiovascular outcomes in patients undergoing noncardiac surgery is unknown. Methods The study population was composed of 660 consecutive adults aged 18 years and over (mean age = 65.3 ± 14 years) who underwent intermediate-risk (nonvascular), noncardiac surgery between January 2010 and February 2011. Nonemergency, non-day-case, open surgical procedures were enrolled. Aortic stiffness indices were calculated from the aortic diameters measured by echocardiography. Electrocardiography and cardiac biomarkers were evaluated 1 day before surgery, and on days 1, 3, and 7 after surgery. Results Eighty patients (12.1%) experienced perioperative cardiovascular events (PCE). Preoperative aortic distensibility (AD) (2 ± 1.3 vs. 2.9 ± 1.1 $ cm^{2} $/dyn/$ 10^{3} $, P < 0.001) and aortic strain (AS) (4.4 ± 2.4 vs. 6.4 ± 1.9, P < 0.001) of the patients with PCE were significantly lower than in patients without PCE. Univariate analysis showed a significant association between age, diabetes mellitus (DM), coronary artery disease, preoperative atrial fibrillation, American Society of Anesthesiologists (ASA) status, Revised Cardiac Risk Index, left ventricle ejection fraction (LVEF), AD, aortic strain, and in-hospital PCE. However, on multivariate logistic regression analysis, only AD (OR: 1.94, 95% CI: 1.1–3.4; P = 0.02), AS (OR: 0.45, 95% CI: 0.3–0.6; P < 0.001), DM (OR: 2.28, 95% CI: 1.08–4.82; P = 0.03), and LVEF (OR: 0.96, 95% CI: 0.93–0.99; P = 0.03) remained as significant variables associated with PCE. Conclusion Impaired elastic properties of the aorta are associated with increased PCE rates in patients undergoing noncardiac, nonvascular surgery. Aortic Stiffness (dpeaa)DE-He213 Leave Ventricle Ejection Fraction (dpeaa)DE-He213 Aortic Distensibility (dpeaa)DE-He213 Revise Cardiac Risk Index (dpeaa)DE-He213 Cardiac Risk Index (dpeaa)DE-He213 Duman, Dursun aut Dayan, Akın aut İlhan, Erkan aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 35(2011), 11 vom: 09. Sept. (DE-627)SPR003391159 nnns volume:35 year:2011 number:11 day:09 month:09 https://dx.doi.org/10.1007/s00268-011-1268-3 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 35 2011 11 09 09 |
| allfieldsGer |
10.1007/s00268-011-1268-3 doi (DE-627)SPR00343110X (SPR)s00268-011-1268-3-e DE-627 ger DE-627 rakwb eng Biteker, Murat verfasserin aut Increased Aortic Stiffness Can Predict Perioperative Cardiovascular Outcomes in Patients Undergoing Noncardiac, Nonvascular Surgery 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2011 Background Aortic stiffness is an early marker of arteriosclerosis and associated with cardiovascular mortality. However, the impact of aortic stiffness on perioperative cardiovascular outcomes in patients undergoing noncardiac surgery is unknown. Methods The study population was composed of 660 consecutive adults aged 18 years and over (mean age = 65.3 ± 14 years) who underwent intermediate-risk (nonvascular), noncardiac surgery between January 2010 and February 2011. Nonemergency, non-day-case, open surgical procedures were enrolled. Aortic stiffness indices were calculated from the aortic diameters measured by echocardiography. Electrocardiography and cardiac biomarkers were evaluated 1 day before surgery, and on days 1, 3, and 7 after surgery. Results Eighty patients (12.1%) experienced perioperative cardiovascular events (PCE). Preoperative aortic distensibility (AD) (2 ± 1.3 vs. 2.9 ± 1.1 $ cm^{2} $/dyn/$ 10^{3} $, P < 0.001) and aortic strain (AS) (4.4 ± 2.4 vs. 6.4 ± 1.9, P < 0.001) of the patients with PCE were significantly lower than in patients without PCE. Univariate analysis showed a significant association between age, diabetes mellitus (DM), coronary artery disease, preoperative atrial fibrillation, American Society of Anesthesiologists (ASA) status, Revised Cardiac Risk Index, left ventricle ejection fraction (LVEF), AD, aortic strain, and in-hospital PCE. However, on multivariate logistic regression analysis, only AD (OR: 1.94, 95% CI: 1.1–3.4; P = 0.02), AS (OR: 0.45, 95% CI: 0.3–0.6; P < 0.001), DM (OR: 2.28, 95% CI: 1.08–4.82; P = 0.03), and LVEF (OR: 0.96, 95% CI: 0.93–0.99; P = 0.03) remained as significant variables associated with PCE. Conclusion Impaired elastic properties of the aorta are associated with increased PCE rates in patients undergoing noncardiac, nonvascular surgery. Aortic Stiffness (dpeaa)DE-He213 Leave Ventricle Ejection Fraction (dpeaa)DE-He213 Aortic Distensibility (dpeaa)DE-He213 Revise Cardiac Risk Index (dpeaa)DE-He213 Cardiac Risk Index (dpeaa)DE-He213 Duman, Dursun aut Dayan, Akın aut İlhan, Erkan aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 35(2011), 11 vom: 09. Sept. (DE-627)SPR003391159 nnns volume:35 year:2011 number:11 day:09 month:09 https://dx.doi.org/10.1007/s00268-011-1268-3 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 35 2011 11 09 09 |
| allfieldsSound |
10.1007/s00268-011-1268-3 doi (DE-627)SPR00343110X (SPR)s00268-011-1268-3-e DE-627 ger DE-627 rakwb eng Biteker, Murat verfasserin aut Increased Aortic Stiffness Can Predict Perioperative Cardiovascular Outcomes in Patients Undergoing Noncardiac, Nonvascular Surgery 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2011 Background Aortic stiffness is an early marker of arteriosclerosis and associated with cardiovascular mortality. However, the impact of aortic stiffness on perioperative cardiovascular outcomes in patients undergoing noncardiac surgery is unknown. Methods The study population was composed of 660 consecutive adults aged 18 years and over (mean age = 65.3 ± 14 years) who underwent intermediate-risk (nonvascular), noncardiac surgery between January 2010 and February 2011. Nonemergency, non-day-case, open surgical procedures were enrolled. Aortic stiffness indices were calculated from the aortic diameters measured by echocardiography. Electrocardiography and cardiac biomarkers were evaluated 1 day before surgery, and on days 1, 3, and 7 after surgery. Results Eighty patients (12.1%) experienced perioperative cardiovascular events (PCE). Preoperative aortic distensibility (AD) (2 ± 1.3 vs. 2.9 ± 1.1 $ cm^{2} $/dyn/$ 10^{3} $, P < 0.001) and aortic strain (AS) (4.4 ± 2.4 vs. 6.4 ± 1.9, P < 0.001) of the patients with PCE were significantly lower than in patients without PCE. Univariate analysis showed a significant association between age, diabetes mellitus (DM), coronary artery disease, preoperative atrial fibrillation, American Society of Anesthesiologists (ASA) status, Revised Cardiac Risk Index, left ventricle ejection fraction (LVEF), AD, aortic strain, and in-hospital PCE. However, on multivariate logistic regression analysis, only AD (OR: 1.94, 95% CI: 1.1–3.4; P = 0.02), AS (OR: 0.45, 95% CI: 0.3–0.6; P < 0.001), DM (OR: 2.28, 95% CI: 1.08–4.82; P = 0.03), and LVEF (OR: 0.96, 95% CI: 0.93–0.99; P = 0.03) remained as significant variables associated with PCE. Conclusion Impaired elastic properties of the aorta are associated with increased PCE rates in patients undergoing noncardiac, nonvascular surgery. Aortic Stiffness (dpeaa)DE-He213 Leave Ventricle Ejection Fraction (dpeaa)DE-He213 Aortic Distensibility (dpeaa)DE-He213 Revise Cardiac Risk Index (dpeaa)DE-He213 Cardiac Risk Index (dpeaa)DE-He213 Duman, Dursun aut Dayan, Akın aut İlhan, Erkan aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 35(2011), 11 vom: 09. Sept. (DE-627)SPR003391159 nnns volume:35 year:2011 number:11 day:09 month:09 https://dx.doi.org/10.1007/s00268-011-1268-3 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 35 2011 11 09 09 |
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However, the impact of aortic stiffness on perioperative cardiovascular outcomes in patients undergoing noncardiac surgery is unknown. Methods The study population was composed of 660 consecutive adults aged 18 years and over (mean age = 65.3 ± 14 years) who underwent intermediate-risk (nonvascular), noncardiac surgery between January 2010 and February 2011. Nonemergency, non-day-case, open surgical procedures were enrolled. Aortic stiffness indices were calculated from the aortic diameters measured by echocardiography. Electrocardiography and cardiac biomarkers were evaluated 1 day before surgery, and on days 1, 3, and 7 after surgery. Results Eighty patients (12.1%) experienced perioperative cardiovascular events (PCE). Preoperative aortic distensibility (AD) (2 ± 1.3 vs. 2.9 ± 1.1 $ cm^{2} $/dyn/$ 10^{3} $, P < 0.001) and aortic strain (AS) (4.4 ± 2.4 vs. 6.4 ± 1.9, P < 0.001) of the patients with PCE were significantly lower than in patients without PCE. Univariate analysis showed a significant association between age, diabetes mellitus (DM), coronary artery disease, preoperative atrial fibrillation, American Society of Anesthesiologists (ASA) status, Revised Cardiac Risk Index, left ventricle ejection fraction (LVEF), AD, aortic strain, and in-hospital PCE. However, on multivariate logistic regression analysis, only AD (OR: 1.94, 95% CI: 1.1–3.4; P = 0.02), AS (OR: 0.45, 95% CI: 0.3–0.6; P < 0.001), DM (OR: 2.28, 95% CI: 1.08–4.82; P = 0.03), and LVEF (OR: 0.96, 95% CI: 0.93–0.99; P = 0.03) remained as significant variables associated with PCE. 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Biteker, Murat |
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Increased Aortic Stiffness Can Predict Perioperative Cardiovascular Outcomes in Patients Undergoing Noncardiac, Nonvascular Surgery Aortic Stiffness (dpeaa)DE-He213 Leave Ventricle Ejection Fraction (dpeaa)DE-He213 Aortic Distensibility (dpeaa)DE-He213 Revise Cardiac Risk Index (dpeaa)DE-He213 Cardiac Risk Index (dpeaa)DE-He213 |
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increased aortic stiffness can predict perioperative cardiovascular outcomes in patients undergoing noncardiac, nonvascular surgery |
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Increased Aortic Stiffness Can Predict Perioperative Cardiovascular Outcomes in Patients Undergoing Noncardiac, Nonvascular Surgery |
| abstract |
Background Aortic stiffness is an early marker of arteriosclerosis and associated with cardiovascular mortality. However, the impact of aortic stiffness on perioperative cardiovascular outcomes in patients undergoing noncardiac surgery is unknown. Methods The study population was composed of 660 consecutive adults aged 18 years and over (mean age = 65.3 ± 14 years) who underwent intermediate-risk (nonvascular), noncardiac surgery between January 2010 and February 2011. Nonemergency, non-day-case, open surgical procedures were enrolled. Aortic stiffness indices were calculated from the aortic diameters measured by echocardiography. Electrocardiography and cardiac biomarkers were evaluated 1 day before surgery, and on days 1, 3, and 7 after surgery. Results Eighty patients (12.1%) experienced perioperative cardiovascular events (PCE). Preoperative aortic distensibility (AD) (2 ± 1.3 vs. 2.9 ± 1.1 $ cm^{2} $/dyn/$ 10^{3} $, P < 0.001) and aortic strain (AS) (4.4 ± 2.4 vs. 6.4 ± 1.9, P < 0.001) of the patients with PCE were significantly lower than in patients without PCE. Univariate analysis showed a significant association between age, diabetes mellitus (DM), coronary artery disease, preoperative atrial fibrillation, American Society of Anesthesiologists (ASA) status, Revised Cardiac Risk Index, left ventricle ejection fraction (LVEF), AD, aortic strain, and in-hospital PCE. However, on multivariate logistic regression analysis, only AD (OR: 1.94, 95% CI: 1.1–3.4; P = 0.02), AS (OR: 0.45, 95% CI: 0.3–0.6; P < 0.001), DM (OR: 2.28, 95% CI: 1.08–4.82; P = 0.03), and LVEF (OR: 0.96, 95% CI: 0.93–0.99; P = 0.03) remained as significant variables associated with PCE. Conclusion Impaired elastic properties of the aorta are associated with increased PCE rates in patients undergoing noncardiac, nonvascular surgery. © Société Internationale de Chirurgie 2011 |
| abstractGer |
Background Aortic stiffness is an early marker of arteriosclerosis and associated with cardiovascular mortality. However, the impact of aortic stiffness on perioperative cardiovascular outcomes in patients undergoing noncardiac surgery is unknown. Methods The study population was composed of 660 consecutive adults aged 18 years and over (mean age = 65.3 ± 14 years) who underwent intermediate-risk (nonvascular), noncardiac surgery between January 2010 and February 2011. Nonemergency, non-day-case, open surgical procedures were enrolled. Aortic stiffness indices were calculated from the aortic diameters measured by echocardiography. Electrocardiography and cardiac biomarkers were evaluated 1 day before surgery, and on days 1, 3, and 7 after surgery. Results Eighty patients (12.1%) experienced perioperative cardiovascular events (PCE). Preoperative aortic distensibility (AD) (2 ± 1.3 vs. 2.9 ± 1.1 $ cm^{2} $/dyn/$ 10^{3} $, P < 0.001) and aortic strain (AS) (4.4 ± 2.4 vs. 6.4 ± 1.9, P < 0.001) of the patients with PCE were significantly lower than in patients without PCE. Univariate analysis showed a significant association between age, diabetes mellitus (DM), coronary artery disease, preoperative atrial fibrillation, American Society of Anesthesiologists (ASA) status, Revised Cardiac Risk Index, left ventricle ejection fraction (LVEF), AD, aortic strain, and in-hospital PCE. However, on multivariate logistic regression analysis, only AD (OR: 1.94, 95% CI: 1.1–3.4; P = 0.02), AS (OR: 0.45, 95% CI: 0.3–0.6; P < 0.001), DM (OR: 2.28, 95% CI: 1.08–4.82; P = 0.03), and LVEF (OR: 0.96, 95% CI: 0.93–0.99; P = 0.03) remained as significant variables associated with PCE. Conclusion Impaired elastic properties of the aorta are associated with increased PCE rates in patients undergoing noncardiac, nonvascular surgery. © Société Internationale de Chirurgie 2011 |
| abstract_unstemmed |
Background Aortic stiffness is an early marker of arteriosclerosis and associated with cardiovascular mortality. However, the impact of aortic stiffness on perioperative cardiovascular outcomes in patients undergoing noncardiac surgery is unknown. Methods The study population was composed of 660 consecutive adults aged 18 years and over (mean age = 65.3 ± 14 years) who underwent intermediate-risk (nonvascular), noncardiac surgery between January 2010 and February 2011. Nonemergency, non-day-case, open surgical procedures were enrolled. Aortic stiffness indices were calculated from the aortic diameters measured by echocardiography. Electrocardiography and cardiac biomarkers were evaluated 1 day before surgery, and on days 1, 3, and 7 after surgery. Results Eighty patients (12.1%) experienced perioperative cardiovascular events (PCE). Preoperative aortic distensibility (AD) (2 ± 1.3 vs. 2.9 ± 1.1 $ cm^{2} $/dyn/$ 10^{3} $, P < 0.001) and aortic strain (AS) (4.4 ± 2.4 vs. 6.4 ± 1.9, P < 0.001) of the patients with PCE were significantly lower than in patients without PCE. Univariate analysis showed a significant association between age, diabetes mellitus (DM), coronary artery disease, preoperative atrial fibrillation, American Society of Anesthesiologists (ASA) status, Revised Cardiac Risk Index, left ventricle ejection fraction (LVEF), AD, aortic strain, and in-hospital PCE. However, on multivariate logistic regression analysis, only AD (OR: 1.94, 95% CI: 1.1–3.4; P = 0.02), AS (OR: 0.45, 95% CI: 0.3–0.6; P < 0.001), DM (OR: 2.28, 95% CI: 1.08–4.82; P = 0.03), and LVEF (OR: 0.96, 95% CI: 0.93–0.99; P = 0.03) remained as significant variables associated with PCE. Conclusion Impaired elastic properties of the aorta are associated with increased PCE rates in patients undergoing noncardiac, nonvascular surgery. © Société Internationale de Chirurgie 2011 |
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