title: Association of carotid arterial circumferential strain with left ventricular function and hemodynamic compromise during off-pump coronary artery bypass surgery.
abstract: BACKGROUND
  Considering the importance of ventricular-vascular coupling, a measure of arterial stiffness may reflect global myocardial performance. We evaluated the predictive value of common carotid arterial circumferential strain (CCA CirS), measured with ultrasound speckle tracking, for hemodynamic deterioration during off-pump coronary artery bypass (OPCAB) and assessed its association with echocardiographic indices of myocardial function.
  
  
  RESULTS
  Patients with left ventricular ejection fraction (LVEF) ≥50% were enrolled. Intraoperative hemodynamic variables were compared in relation to CCA CirS tertiles. A total of 96 patients were analyzed. Mixed venous oxygen saturation (SvO2) during left circumflex artery grafting and sternum closure were lower in the first tertile than in the third tertile. On univariate logistic regression female gender, ratio of early transmitral velocity to annular velocity, pulse pressure, and CCA CirS were predictors of hemodynamic deterioration (defined as decrease in SvO2≥20%), while only CCA CirS remained as an independent predictor after multivariate analysis (OR, 0.27; 95% CI: 0.11-0.68). Area under the curve of CCA CirS for its prediction was 0.730 (95% CI: 0.608-0.852). CCA CirS was strongly associated with tissue Doppler-derived parameters of LV function.
  
  
  CONCLUSIONS
  CCA CirS is a comprehensive marker reflecting LV function, and a predictor for hemodynamic deterioration during OPCAB in patients with preserved LVEF.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine.
authors.forename: Young
authors.initials: Y
authors.lastname: Song
authors.forename: Jae-Kwang
authors.initials: JK
authors.lastname: Shim
authors.forename: Jong-Wook
authors.initials: JW
authors.lastname: Song
authors.forename: Chi-Young
authors.initials: CY
authors.lastname: Shim
authors.forename: Eui-Kyung
authors.initials: EK
authors.lastname: Kim
authors.forename: Young-Lan
authors.initials: YL
authors.lastname: Kwak
mesh_terms: D000368:Aged; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume; D014463:Ultrasonography; D059289:Vascular Stiffness; D016277:Ventricular Function, Left