title: Association of Preoperative Right and Left Ventricular Diastolic Dysfunction With Postoperative Atrial Fibrillation in Patients Undergoing Lung Surgery: A Prospective Observational Study.
abstract: OBJECTIVE
  To clarify the relationship between right and left ventricular (RV and LV) diastolic function and postoperative atrial fibrillation (POAF). The early effects of major lung surgery on cardiac function in the intraoperative period during lung surgery were evaluated, using transesophageal echocardiography.
  
  
  METHODS
  Single-center prospective observational study.
  
  
  METHODS
  A public hospital.
  
  
  METHODS
  Patients undergoing elective lobectomy with lymph node dissection for lung cancer (n = 116).
  
  
  METHODS
  Transesophageal echocardiography examination was performed under general anesthesia before skin incision (preoperative) and after chest closure (postoperative). According to measured echocardiographic variables, ventricular systolic and diastolic functions were classified at each time point.
  
  
  RESULTS
  Of the 116 patients, 24 (20.7%) experienced POAF. Preoperative RV and LV diastolic dysfunction were more common in patients with POAF than in those without POAF (58.3 v 28.3%, p = 0.008; 54.2 v 19.6%, p = 0.001, respectively). Among patients without preoperative diastolic dysfunction, a small number developed RV and LV diastolic dysfunction immediately after surgery (9.2% and 16.5%, respectively) and these distributions were comparable between patients with POAF and those without POAF. RV systolic dysfunction was observed in 6.5% of patients immediately after surgery and was not related to the occurrence of POAF. Multivariate analysis revealed older age, chronic obstructive pulmonary disease (COPD), and preoperative biventricular diastolic dysfunction as risk factors for POAF.
  
  
  CONCLUSIONS
  Preoperative biventricular diastolic dysfunction, as well as older age and COPD, are associated with POAF in patients undergoing lobectomy. Major lung surgery has minimal early effects on postoperative systolic and diastolic functions.
authors.affiliation: Department of Anesthesiology, Saitama Cardiovascular and Respiratory Center, Kumagaya City, Japan. Electronic address: mita.norikatsu@gmail.com.
authors.forename: Norikatsu
authors.initials: N
authors.lastname: Mita
authors.affiliation: Department of Anesthesiology, Gunma University Graduate School of Medicine, Maebashi City, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Kuroda
authors.affiliation: Department of Anesthesiology, Saitama Cardiovascular and Respiratory Center, Kumagaya City, Japan.
authors.forename: Sohtaro
authors.initials: S
authors.lastname: Miyoshi
authors.affiliation: Department of Anesthesiology, Gunma University Graduate School of Medicine, Maebashi City, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Saito
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D013510:Pulmonary Surgical Procedures / Q000009:adverse effects*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery
keywords: postoperative atrial fibrillation, right ventricular diastolic dysfunction, left ventricular diastolic dysfunction; transesophageal echocardiography