Results
A total of 68 patients followed with sinus rhythm after CABG were
defined as “Group 1”, and a total of 25 patients developing PoAF
(patients who developed AF episode lasting at least 5 minutes during the
postoperative period) were defined as “Group 2”.
The PoAF development rate was 26.88% (n = 25) in 93 patients who were
included in our study, and the average AF development time was 2.80 ±
1.77 days. The demographic and clinical characteristics of the patients
are presented in Table 1. The mean age, hypertension rate and diuretic
use rate of patients in Group 2 were significantly higher than those in
Group 1 (p = 0.014, p = 0.03, p = 0.01; respectively).
The preoperative laboratory data of the patients are presented in Table
1. No statistically significant differences were detected between the
groups in terms of hemogram parameters, renal function tests,
electrolytes, and lipid profiles. When the preoperative TTE measurements
of the patients were evaluated, it was detected that the mean LA maximum
volume and pulmonary artery pressure (PAP) were significantly higher in
Group 2 (p = 0.002, p = 0.012; respectively); the mean LV lateral Ea
velocities and LV medial Ea velocities were significantly lower (p =
0.006, p = 0.02; respectively) (Table 2).
The only intraaortic balloon pump support need, which is among the
assessed perioperative variables, was significantly more in Group 2 (p =
0.02). No significant differences were detected between the groups in
terms of the CABG times, CPB times, cross-clamp times, and the number of
grafts used, which indicated that similar surgical procedures were
performed. The average length of stay in the intensive care unit, which
is among the postoperative variables, was significantly higher in Group
2 (p = 0.009). Also, no significant differences were detected between
the groups in terms of the postoperative laboratory parameters that were
evaluated (Table 3).
The average AEMD durations of the patient groups are presented in Table
2. The LV lateral AEMD, LV medial AEMD, RV lateral AEMD and LA lateral
AEMD durations were significantly longer in Group 2 than in Group 1 (p
< 0.001, p = 0.004, p = 0.004, p <0.001;
respectively).
The variables that were associated with the development of PoAF were
included in the Univariate Logistic Regression Analysis. Age,
hypertension, LA maximum volume, LA lateral AEMD and PAP were found to
be significantly associated with PoAF development (p = 0.01, p = 0.004,
p = 0.004, p = 0.001, p = 0.01; respectively). These variables, which
were found to be statistically significant, were included in the
Multivariate Logistic Regression Analysis. The LA lateral AEMD variable
was found to be an independent predictive factor for PoAF development
(OR: 1.03, 95% CI: 1,001-1.06, p = 0.04) (Table 4).
ROC Curve Analysis was conducted to determine the predictive effect of
AEMD in PoAF development. For LV lateral AEMD, the Area Under the Curve
(AUC) was 0.764 (95% CI: 0.652-0.876, p < 0.001). For LV
medial AEMD, AUC was 0.686 (95% CI: 0.567-0.806, p = 0.006). For RV
lateral AEMD, AUC was 0.706 (95% CI: 0.588-0.823, p = 0.002). For LA
lateral AEMD, AUC was 0.741 (95% CI: 0.633-0.849, p < 0.001)
(Figure 2).
Intra-observer agreement was higher than 0.90, p<0.001, for
all AEMD parameters.