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.