Abstract 1798: Increased Arterial Wave Reflection is Independently Associated with Atrial Fibrillation after Cardiac Surgery
Background: Increased arterial wave reflection due to reduced compliance of the arterial vasculature leads to a systolic central aortic pressure rise that increases afterload and myocardial oxygen demand. The relationship of this augmented pressure (AP) and postoperative AF (POAF) has not been investigated.
Methods: 145 patients (mean age 63 years) undergoing CABG, aortic valve surgery or myectomy were prospectively enrolled. Clinical risk factors for POAF were assessed by a standardized patient interview and review of medical records. On the day before surgery, AP was noninvasively assessed with radial tonometry using the Sphygmocor® device. Cardiac systolic (ejection fraction, EF) and diastolic function (DFG) were evaluated with echocardiography. POAF was documented by continuous postoperative telemetry until discharge.
Results: 59 (41%) patients experienced POAF after a mean of 2.7 days. AP was higher in patients with POAF (15.6 mmHg vs. 10.8 mmHg, p = 0.001). In a multivariable Cox model, apart from age, AP was the only independent predictor of POAF (p = 0.005). Patients with AP > 5 mmHg had a significantly worse survival free from POAF (p < 0.05).
Conclusion: The amount of augmented central aortic pressure due to arterial wave reflection is strongly associated with POAF.