title: Predictors and Clinical Impacts of Aggravated Left Ventricular Diastolic Dysfunction After Off-Pump Coronary Artery Bypass Grafting.
abstract: BACKGROUND
  To determine the predictors of aggravated left ventricular diastolic dysfunction (LVDD) in patients undergoing off-pump coronary artery bypass grafting (OPCAB) and to compare late outcomes according to the aggravated LVDD.
  
  
  RESULTS
  OPCAB was performed in 1,101 patients (2001-2013). LVDD was classified as normal, mild, moderate or severe. Patients were divided into 2 groups: non-aggravated LVDD (group I) and aggravated LVDD (group II). The primary endpoint was aggravation of LVDD. The secondary endpoint was late mortality and morbidity such as major adverse cardiac and cerebrovascular events (MACCE) related to LVDD aggravation postoperatively. There were 894 patients in group I and 207 in group II. Multivariate analysis revealed that preoperative peripheral artery obstructive disease (PAOD) (P=0.04), renal failure (P<0.01), and A' velocity (P<0.01) anticipated aggravated LVDD. The Cox hazards model revealed that aggravated LVDD was a poor prognostic factor for MACCE (P<0.01) and overall survival (P<0.01). The Kaplan-Meier survival curve showed that aggravated LVDD was related to poor late outcomes (freedom from MACCE, P=0.01; overall survival, P<0.01).
  
  
  CONCLUSIONS
  Aggravated LVDD significantly affects late clinical outcomes after OPCAB and preoperative PAOD, renal failure, and A' velocity might be predictors. (Circ J 2016; 80: 1937-1945).
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University Health System.
authors.forename: Seung Hyun
authors.initials: SH
authors.lastname: Lee
authors.forename: Kwan Wook
authors.initials: KW
authors.lastname: Kim
authors.forename: Hyun-Chel
authors.initials: HC
authors.lastname: Joo
authors.forename: Kyung-Jong
authors.initials: KJ
authors.lastname: Yoo
authors.forename: Young-Nam
authors.initials: YN
authors.lastname: Youn
mesh_terms: D000368:Aged; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000401:mortality / Q000503:physiopathology