Multivariate analysis of predictive effect of echocardiogram on atrial fibrillation after coronary artery bypass grafting

Objective To probe into the predictive effect of echocardiogram on atrial fibrillation after off-pump coronary artery bypass grafting (OPCAB). Methods The case-control method was adopted to analyze 113 patients undergoing OPCAB. These patients were divided into AF and control groups based on the occurrence of atrial fibrillation. Multiple regression analysis was conducted on collected clinical data and echocardiographic data. Results Postoperative atrial fibrillation (POAF) occurred in 31 out of 113 patients (27.4%). Univariate analysis showed that age, wall motion integral (WMI), ratio of early (E) and late (A) transmitral inflow peak velocity (E/A), systolic peak velocity at lateral mitral annulus (S'), ratio of E and early diastolic peak velocities of lateral mitral annulus (E/E'), pulmonary artery systolic pressure (PASP), and mitral insufficiency (MI) were significantly different between the AF and control groups ( P <0.05). However, multiple regression analysis showed that independent risk factors of POAF were ranged as MI, E/E', age, and PASP according to relative risk. Thirteen patients (72.2%) in the AF group still suffered from MI after the operation, but only 6 patients (23.1%) in control group had MI by analyzing the postoperative mitral valve regurgitation of 44 patients with preoperative MI (AF group 18 cases and control group 26 cases). A significant difference existed between two groups ( P =0.001), whereas the MI of the other 25 patients decreased or disappeared. In addition, the E/E' in both groups were 13.5±4.9 and 9.9±3.2, respectively, which showed a significant difference ( P =0.005). Conclusion Independent risk factors in POAF of CABG are MI, E/E', age and PASP. Mitral valvuloplasty and CABG should be completed simultaneously in the MI patients with left ventricular diastolic dysfunction (E/E'≥8-10).