title: Association between renal function, diastolic dysfunction, and postoperative atrial fibrillation following cardiac surgery.
abstract: BACKGROUND
  Renal dysfunction is associated with a higher rate of atrial fibrillation in clinical practice. This study investigated the associations between renal function, left ventricular (LV) diastolic dysfunction, and postoperative atrial fibrillation (POAF).
  
  
  RESULTS
  A total of 265 consecutive patients who underwent cardiac surgery were prospectively enrolled in the study. Echocardiography was performed before cardiac surgery. The patients were divided into 3 groups based on estimated glomerular filtration rate (eGFR) (group 1, ≥90ml·min(-1)·1.73m(-2); group 2, 60-90ml·min(-1)·1.73m(-2); and group 3, <60ml·min(-1)·1.73m(-2)). POAF occurred in 83 of 265 patients (31.3%). The rate of new-onset POAF increased from 15.2% (12/79) in group 1 to 27.8% (27/97) in group 2 and 49.4% (44/89) in group 3 (P<0.001). Further, with increasing renal dysfunction from groups 1 to 3, the rate of LV diastolic dysfunction - defined as E/e' >15 - also increased (group 1, 19.0%; group 2, 38.1%; and group 3, 48.3%; P<0.001). Absolute eGFR was significantly correlated with E/e' ratio (r=-0.39, P<0.001). Renal function remained as the independent predictor of POAF on multivariate analysis (odds ratio, 1.90; 95% confidence interval: 1.26-2.87; P=0.002).
  
  
  CONCLUSIONS
  In patients undergoing cardiac surgery, decreased eGFR was associated with an increased rate of LV diastolic dysfunction with a subsequent increase in the rate of POAF.
authors: Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University.
authors: Su-Kiat
authors: SK
authors: Chua
authors: Kou-Gi
authors: KG
authors: Shyu
authors: Ming-Jen
authors: MJ
authors: Lu
authors: Huei-Fong
authors: HF
authors: Hung
authors: Jun-Jack
authors: JJ
authors: Cheng
authors: Shih-Huang
authors: SH
authors: Lee
authors: Chia-Hsun
authors: CH
authors: Lin
authors: Hung-Hsing
authors: HH
authors: Chao
authors: Huey-Ming
authors: HM
authors: Lo
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003971:Diastole; D004452:Echocardiography; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D011446:Prospective Studies