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Estimation of myocardial performance in CABG patients

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Abstract
Myocardial performance index (MPI) permits a relative easy estimation of global left ventricular (LV) systolic and diastolic function. It was shown that MPI inversely correlated strongly with the maximum derivative of LV pressure with respect to time (+dP/dtmax). The current study evaluated the change of MPI during and immediately after coronary artery bypass surgery (CABG) surgery and analyzed the relationship between MPI and hydraulic energy (exemplified by preload adjusted maximal power - PAMP) during that same period. The study was conducted in 45 patients undergoing CABG. After induction of anaesthesia, 10 min after revascularization and 2 h postoperatively, haemodynamics were assessed. Preload was characterized by LV end-diastolic area indexed for BSA (LVEDAI); afterload was estimated by arterial elastance (Ea) and indexed systemic vascular resistance (SVRI). Global myocardial performance was indicated in terms of MPI and contractility was achieved by PAMP. Myocardial performance index increased postoperatively (0.44 +/- 0.13, 0.37 +/- 0.17 and 0.50 +/- 0.16, respectively; P < 0.001). Preload adjusted maximal power did not alter significantly (1.90 +/- 1.24, 2.02 +/- 1.34 and 2.12 +/- 1.00 W cm(-2)*10(4), respectively). Left ventricular enddiastolic area indexed did not change. Arterial elastance augmented to 0.76 +/- 0.39, 0.80 +/- 0.40 and 1.01 +/- 0.43 mmHg ml(-1), respectively; P < 0.001. Systemic vascular resistance did not change. A relationship was found between 1-MPI/LVEDAI(2) and PAMP (R-2 = 0.50). This study shows that in the setting of CABG surgery, MPI appears to be a good measure of global LV function.
Keywords
echocardiography, contractility, haemodynamics, performance, SYSTOLIC-TIME INTERVALS, ADJUSTED MAXIMAL POWER, LEFT-VENTRICULAR CONTRACTILITY, CONTINUOUS-WAVE DOPPLER, TRANSESOPHAGEAL ECHOCARDIOGRAPHY, QUANTITATIVE ASSESSMENT, HEMODYNAMIC INDEXES, CARDIAC-OUTPUT, PRELOAD, AFTERLOAD

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MLA
Poelaert, Jan, JAN HEERMAN, G Schüpfer, et al. “Estimation of Myocardial Performance in CABG Patients.” ACTA ANAESTHESIOLOGICA SCANDINAVICA 48.8 (2004): 973–979. Print.
APA
Poelaert, J., HEERMAN, J., Schüpfer, G., Moerman, A., REYNTJENS, K., & Roosens, C. (2004). Estimation of myocardial performance in CABG patients. ACTA ANAESTHESIOLOGICA SCANDINAVICA, 48(8), 973–979.
Chicago author-date
Poelaert, Jan, JAN HEERMAN, G Schüpfer, Anneliese Moerman, KOEN REYNTJENS, and Carl Roosens. 2004. “Estimation of Myocardial Performance in CABG Patients.” Acta Anaesthesiologica Scandinavica 48 (8): 973–979.
Chicago author-date (all authors)
Poelaert, Jan, JAN HEERMAN, G Schüpfer, Anneliese Moerman, KOEN REYNTJENS, and Carl Roosens. 2004. “Estimation of Myocardial Performance in CABG Patients.” Acta Anaesthesiologica Scandinavica 48 (8): 973–979.
Vancouver
1.
Poelaert J, HEERMAN J, Schüpfer G, Moerman A, REYNTJENS K, Roosens C. Estimation of myocardial performance in CABG patients. ACTA ANAESTHESIOLOGICA SCANDINAVICA. 2004;48(8):973–9.
IEEE
[1]
J. Poelaert, J. HEERMAN, G. Schüpfer, A. Moerman, K. REYNTJENS, and C. Roosens, “Estimation of myocardial performance in CABG patients,” ACTA ANAESTHESIOLOGICA SCANDINAVICA, vol. 48, no. 8, pp. 973–979, 2004.
@article{306307,
  abstract     = {Myocardial performance index (MPI) permits a relative easy estimation of global left ventricular (LV) systolic and diastolic function. It was shown that MPI inversely correlated strongly with the maximum derivative of LV pressure with respect to time (+dP/dtmax). The current study evaluated the change of MPI during and immediately after coronary artery bypass surgery (CABG) surgery and analyzed the relationship between MPI and hydraulic energy (exemplified by preload adjusted maximal power - PAMP) during that same period. The study was conducted in 45 patients undergoing CABG. After induction of anaesthesia, 10 min after revascularization and 2 h postoperatively, haemodynamics were assessed. Preload was characterized by LV end-diastolic area indexed for BSA (LVEDAI); afterload was estimated by arterial elastance (Ea) and indexed systemic vascular resistance (SVRI). Global myocardial performance was indicated in terms of MPI and contractility was achieved by PAMP. Myocardial performance index increased postoperatively (0.44 +/- 0.13, 0.37 +/- 0.17 and 0.50 +/- 0.16, respectively; P < 0.001). Preload adjusted maximal power did not alter significantly (1.90 +/- 1.24, 2.02 +/- 1.34 and 2.12 +/- 1.00 W cm(-2)*10(4), respectively). Left ventricular enddiastolic area indexed did not change. Arterial elastance augmented to 0.76 +/- 0.39, 0.80 +/- 0.40 and 1.01 +/- 0.43 mmHg ml(-1), respectively; P < 0.001. Systemic vascular resistance did not change. A relationship was found between 1-MPI/LVEDAI(2) and PAMP (R-2 = 0.50). 
This study shows that in the setting of CABG surgery, MPI appears to be a good measure of global LV function.},
  author       = {Poelaert, Jan and HEERMAN, JAN and Schüpfer, G and Moerman, Anneliese and REYNTJENS, KOEN and Roosens, Carl},
  issn         = {0001-5172},
  journal      = {ACTA ANAESTHESIOLOGICA SCANDINAVICA},
  keywords     = {echocardiography,contractility,haemodynamics,performance,SYSTOLIC-TIME INTERVALS,ADJUSTED MAXIMAL POWER,LEFT-VENTRICULAR CONTRACTILITY,CONTINUOUS-WAVE DOPPLER,TRANSESOPHAGEAL ECHOCARDIOGRAPHY,QUANTITATIVE ASSESSMENT,HEMODYNAMIC INDEXES,CARDIAC-OUTPUT,PRELOAD,AFTERLOAD},
  language     = {eng},
  number       = {8},
  pages        = {973--979},
  title        = {Estimation of myocardial performance in CABG patients},
  url          = {http://dx.doi.org/10.1111/j.1399-6576.2004.00466.x},
  volume       = {48},
  year         = {2004},
}

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