caa a22 4500 44537327X CHVBK 20180317142954.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1007/s00540-011-1231-3 doi (NATIONALLICENCE)springer-10.1007/s00540-011-1231-3 Tissue Doppler imaging is useful for predicting the need for inotropic support after cardiac surgery [Elektronische Daten] [Hidekazu Imai, Satoshi Kurokawa, Miki Taneoka, Hiroshi Baba] Purpose: Low preoperative left ventricular ejection fraction (EF) is a predictor of the need for inotropic support after cardiac surgery. However, EF can be misinterpreted and difficult to measure in some cases. The purpose of this study was to compare the value of preoperative EF and intraoperative tissue Doppler imaging variables in predicting the need for postoperative inotropic support. Methods: Forty-eight consecutive adult patients undergoing cardiac surgery were enrolled in this study. Systolic mitral annular velocity (S m), early diastolic mitral annular velocity (E m), the ratio of E m to late diastolic mitral annular velocity (E m/A m), and the ratio of early diastolic transmitral velocity to E m (E/E m) were measured using transesophageal echocardiography before median sternotomy. The primary outcome was the need for inotropic support for 12 or more hours after surgery. Preoperative, intraoperative, and echocardiographic characteristics were analyzed to determine the independent predictors of the need for postoperative inotropic support. Results: Postoperative inotropic support was required for ≥12h in 26.7% of patients. Multivariate logistic regression identified only cardiopulmonary bypass (CPB) time as an independent predictor of inotropic support (odds ratio, 1.015; 95% CI, 1.004-1.025; P=0.004). Additional analysis was performed in the 25 patients with a CPB time of ≥200min. In this analysis, only S m was significantly associated with the need for inotropic support for ≥12h. Conclusions: This study suggests that those patients who have decreased S m and extended CPB times are more likely to require inotropic support after surgery, independent of a preserved left ventricular EF. Japanese Society of Anesthesiologists, 2011 Tissue Doppler imaging (TDI) nationallicence Mitral annular velocity nationallicence Inotropic support nationallicence Cardiac surgery nationallicence Imai Hidekazu Department of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, 951-8510, Niigata, Japan aut Kurokawa Satoshi Department of Anesthesiology, Tokyo Women's Medical University, Tokyo, Japan aut Taneoka Miki Department of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, 951-8510, Niigata, Japan aut Baba Hiroshi Department of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, 951-8510, Niigata, Japan aut Journal of Anesthesia Springer Japan 25/6(2011-12-01), 805-811 0913-8668 25:6<805 2011 25 540 https://doi.org/10.1007/s00540-011-1231-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00540-011-1231-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Imai Hidekazu Department of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, 951-8510, Niigata, Japan aut NATIONALLICENCE 700 1- Kurokawa Satoshi Department of Anesthesiology, Tokyo Women's Medical University, Tokyo, Japan aut NATIONALLICENCE 700 1- Taneoka Miki Department of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, 951-8510, Niigata, Japan aut NATIONALLICENCE 700 1- Baba Hiroshi Department of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, 951-8510, Niigata, Japan aut NATIONALLICENCE 773 0- Journal of Anesthesia Springer Japan 25/6(2011-12-01), 805-811 0913-8668 25:6<805 2011 25 540 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer