caa a22 4500 606220992 CHVBK 20210128101126.0 cr unu---uuuuu 210128e20150501xx s 000 0 eng 10.1007/s00380-014-0486-7 doi (NATIONALLICENCE)springer-10.1007/s00380-014-0486-7 Lower heart rate in the early postoperative period does not correlate with long-term outcomes after repair of type A acute aortic dissection [Elektronische Daten] [Tetsu Ohnuma, Naoyuki Kimura, Yusuke Sasabuchi, Kayo Asaka, Junji Shiotsuka, Tetsuya Komuro, Hideyuki Mouri, Alan Lefor, Hideo Adachi, Masamitsu Sanui] Little evidence exists regarding the need for a reduction in postoperative heart rate after repair of type A acute aortic dissection. This single-center retrospective study was conducted to determine if lower heart rate during the early postoperative phase is associated with improved long-term outcomes after surgery for patients with type A acute aortic dissection. We reviewed 434 patients who underwent aortic repair between 1990 and 2011. Based on the average heart rate on postoperative days 1, 3, 5, and 7, 434 patients were divided into four groups, less than 70, 70-79, 80-89, and greater than 90 beats per minute. The mean age was 63.3±12.1years. During a median follow-up of 52months (range 16-102), 10-year survival in all groups was 67%, and the 10-year aortic event-free rate was 79%. The probability of survival and being aortic event-free using Kaplan-Meier estimates reveal that there is no significant difference when stratified by heart rate. Cox proportional regression analysis for 10-year mortality shows that significant predictors of mortality are age [Hazard Ratio (HR) 1.04; 95% confidence interval (CI) 1.07-1.06; p=0.001] and perioperative stroke (HR 2.30; 95% CI 1.18-4.50; p=0.024). Neither stratified heart rate around the time of surgery nor beta-blocker use at the time of discharge was significant. There is no association between stratified heart rate in the perioperative period with long-term outcomes after repair of type A acute aortic dissection. These findings need clarification with further clinical trials. The Author(s), 2014 Aortic dissection nationallicence Heart rate nationallicence Outcomes nationallicence Surgery nationallicence Ohnuma Tetsu Department of Anesthesiology and Critical Care Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, 330-8503, Saitama-shi, Saitama, Japan aut Kimura Naoyuki Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan aut Sasabuchi Yusuke Department of Anesthesiology and Critical Care Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, 330-8503, Saitama-shi, Saitama, Japan aut Asaka Kayo Department of Anesthesiology and Critical Care Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, 330-8503, Saitama-shi, Saitama, Japan aut Shiotsuka Junji Department of Anesthesiology and Critical Care Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, 330-8503, Saitama-shi, Saitama, Japan aut Komuro Tetsuya Department of Anesthesiology and Critical Care Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, 330-8503, Saitama-shi, Saitama, Japan aut Mouri Hideyuki Department of Anesthesiology and Critical Care Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, 330-8503, Saitama-shi, Saitama, Japan aut Lefor Alan Department of Surgery, Jichi Medical University, Shimotsuke, Japan aut Adachi Hideo Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan aut Sanui Masamitsu Department of Anesthesiology and Critical Care Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, 330-8503, Saitama-shi, Saitama, Japan aut Heart and Vessels Springer Japan 30/3(2015-05-01), 355-361 0910-8327 30:3<355 2015 30 380 https://doi.org/10.1007/s00380-014-0486-7 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00380-014-0486-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ohnuma Tetsu Department of Anesthesiology and Critical Care Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, 330-8503, Saitama-shi, Saitama, Japan aut NATIONALLICENCE 700 1- Kimura Naoyuki Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan aut NATIONALLICENCE 700 1- Sasabuchi Yusuke Department of Anesthesiology and Critical Care Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, 330-8503, Saitama-shi, Saitama, Japan aut NATIONALLICENCE 700 1- Asaka Kayo Department of Anesthesiology and Critical Care Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, 330-8503, Saitama-shi, Saitama, Japan aut NATIONALLICENCE 700 1- Shiotsuka Junji Department of Anesthesiology and Critical Care Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, 330-8503, Saitama-shi, Saitama, Japan aut NATIONALLICENCE 700 1- Komuro Tetsuya Department of Anesthesiology and Critical Care Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, 330-8503, Saitama-shi, Saitama, Japan aut NATIONALLICENCE 700 1- Mouri Hideyuki Department of Anesthesiology and Critical Care Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, 330-8503, Saitama-shi, Saitama, Japan aut NATIONALLICENCE 700 1- Lefor Alan Department of Surgery, Jichi Medical University, Shimotsuke, Japan aut NATIONALLICENCE 700 1- Adachi Hideo Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan aut NATIONALLICENCE 700 1- Sanui Masamitsu Department of Anesthesiology and Critical Care Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, 330-8503, Saitama-shi, Saitama, Japan aut NATIONALLICENCE 773 0- Heart and Vessels Springer Japan 30/3(2015-05-01), 355-361 0910-8327 30:3<355 2015 30 380