title: Predictive role of left atrial and ventricular mechanical function in postoperative atrial fibrillation: a two-dimensional speckle-tracking echocardiography study.
abstract: OBJECTIVE
  The aim of this study was to determine the role of left-sided mechanical parameters in postoperative atrial fibrillation (POAF) in patients undergoing coronary artery bypass grafting (CABG).
  
  
  METHODS
  Ninety patients with coronary artery disease and normal left ventricular (LV) function in sinus rhythm were enrolled in the study. Preoperative LV and left atrial (LA) mechanics were evaluated by two-dimensional (2D) speckle-tracking echocardiography (STE), including strain and rotation parameters, and volume indices. Patients were monitored in order to detect POAF during the postoperative period.
  
  
  RESULTS
  Twenty-three of 90 patients (25.6%) developed POAF. Age (p<0.001) and preoperative beta blocker usage (p=0.001) were the clinical parameters associated with POAF. Left atrial maximum volume index (LAV[max]i) increased, and peak left atrial longitudinal strain (PALS) was impaired in POAF patients (p=0.001, p<0.001, respectively). Left ventricular twist (LVtw) and left ventricular peak untwisting velocity (UntwV) were augmented in POAF patients (p=0.013, p=0.009, respectively). Receiver operating characteristic analysis showed N-terminal pro-brain natriuretic peptide (NT-proBNP) levels above 70 pg/ml and predicted POAF with a sensitivity of 74% and specificity of 78% (area under curve: 0.758, 95% confidence interval [CI] 0.631-0.894, p<0.001). Logistic regression analysis demonstrated that age (odds ratio [OR] 1.1, CI 1.01-1.20, p=0.034), preoperative beta blocker usage (OR 8.84, CI 1.36-57.28, p=0.022), NT-proBNP (values >70 pg/ml, OR 22.377, CI 3.286-152.381, p<0.001), PALS (OR 0.86, CI 0.75-0.98, p=0.023), and UntwV (OR 1.02, CI 1.00-1.04, p=0.029) were the independent predictors of POAF.
  
  
  CONCLUSIONS
  The combination of 2D STE, clinical, and biochemical parameters may help predict POAF.
authors.affiliation: Department of Cardiology, Muğla Sıtkı Koçman University Faculty of Medicine, Muğla, Turkey. basaran_ozcan@yahoo.com.
authors.forename: Özcan
authors.initials: Ö
authors.lastname: Başaran
authors.affiliation: Department of Cardiology, Marmara University Faculty of Medicine, İstanbul, Turkey.
authors.forename: Kürşat
authors.initials: K
authors.lastname: Tigen
authors.affiliation: Department of Cardiology, Malatya State Hospital, Malatya, Turkey.
authors.forename: Gökhan
authors.initials: G
authors.lastname: Gözübüyük
authors.affiliation: Department of Cardiology, Büyük Meydan Hospital, Samsun, Turkey.
authors.forename: Cihan
authors.initials: C
authors.lastname: Dündar
authors.affiliation: Department of Cardiology, Kartal Koşuyolu Heart Training and Research Hospital, İstanbul, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Güler
authors.affiliation: Department of Cardiology, Elazığ Training and Research Hospital, Elazığ, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Taşar
authors.affiliation: Department of Cardiology, Muğla Sıtkı Koçman University Faculty of Medicine, Muğla, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Biteker
authors.affiliation: Department of Cardiology, Kartal Koşuyolu Heart Training and Research Hospital, İstanbul, Turkey.
authors.forename: Can Yücel
authors.initials: CY
authors.lastname: Karabay
authors.affiliation: Department of Cardiology, Kartal Koşuyolu Heart Training and Research Hospital, İstanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Bulut
authors.affiliation: Department of Cardiology, Acıbadem University Faculty of Medicine, İstanbul, Turkey.
authors.forename: Tansu
authors.initials: T
authors.lastname: Karaahmet
authors.affiliation: Department of Cardiology, Kartal Koşuyolu Heart Training and Research Hospital, İstanbul, Turkey.
authors.forename: Cevat
authors.initials: C
authors.lastname: Kırma
mesh_terms: D000319:Adrenergic beta-Antagonists; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D016279:Atrial Function, Left / Q000502:physiology*; D001026:Coronary Artery Bypass / Q000009:adverse effects; D003324:Coronary Artery Disease / Q000601:surgery; D004452:Echocardiography; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011446:Prospective Studies
chemical_list: D000319:Adrenergic beta-Antagonists; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain