The Association between Arterial Stiffness and Post-cardiac Surgery Renal and Diastolic Heart Functions
Background: Brachial-ankle pulse wave velocity (baPWV), a marker of arterial stiffness (AS), is a well-known non-invasive marker of cardiovascular morbidity but its implication for the cardiac surgery patients has been rarely studied. This study investigated the association between baPWV and post-cardiac surgery renal and left ventricular (LV) diastolic functions. Methods: Among 62 patients prospectively enrolled at a single center, 60 (mean age: 66.8 ± 9.1 years, 53.3% males) completed the whole measurements including baPWV and postoperative morbidity variables. Results: In total, 38 patients (63.3%) underwent non-valvular operations (NV), of which 32 underwent isolated coronary artery bypass grafting. Postoperative estimated glomerular filtration rate (eGFR) was significantly and inversely associated with baPWV, in both univariable and multivariable analyses (P=0.024, regression coefficient (B)=-1.535 and P=0.031, B=-1.190, respectively). In ROC curve analysis of patients undergoing NV for detection of postoperative eGFR <50 mL/min/1.73m2, the cut-off value of baPWV was 18.0m/s with 64.3% sensitivity and 75.0% specificity (AUC, 0.783; 95% CI: 0.631–0.934, P=0.004). For the association with postoperative LV diastolic function which was investigated with tissue Doppler echocardiography in a subgroup of patients undergoing NV, there was a significant trend of decreasing postoperative e′ velocity with increasing quartiles of baPWV: Q1, 6.8 ± 1.2; Q2, 6.3 ± 2.2; Q3, 5.0 ± 1.0; Q4, 5.2 ± 1.5 cm/s (P for trend=0.005). Conclusions: There was a significant inverse association between baPWV and post-cardiac surgery renal and LV diastolic functions. Trial registration: ClinicalTrials.gov (ID: NCT 02014012).