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. 2015 May;30(3):355-61.
doi: 10.1007/s00380-014-0486-7. Epub 2014 Feb 25.

Lower heart rate in the early postoperative period does not correlate with long-term outcomes after repair of type A acute aortic dissection

Tetsu Ohnuma  1 , Naoyuki Kimura, Yusuke Sasabuchi, Kayo Asaka, Junji Shiotsuka, Tetsuya Komuro, Hideyuki Mouri, Alan T Lefor, Hideo Adachi, Masamitsu Sanui
Affiliations

Lower heart rate in the early postoperative period does not correlate with long-term outcomes after repair of type A acute aortic dissection

Tetsu Ohnuma et al. Heart Vessels. 2015 May.

Abstract

Little evidence exists regarding the need for a reduction in postoperative heart rate after repair of type A acute aortic dissection. This single-center retrospective study was conducted to determine if lower heart rate during the early postoperative phase is associated with improved long-term outcomes after surgery for patients with type A acute aortic dissection. We reviewed 434 patients who underwent aortic repair between 1990 and 2011. Based on the average heart rate on postoperative days 1, 3, 5, and 7, 434 patients were divided into four groups, less than 70, 70-79, 80-89, and greater than 90 beats per minute. The mean age was 63.3 ± 12.1 years. During a median follow-up of 52 months (range 16-102), 10-year survival in all groups was 67%, and the 10-year aortic event-free rate was 79%. The probability of survival and being aortic event-free using Kaplan-Meier estimates reveal that there is no significant difference when stratified by heart rate. Cox proportional regression analysis for 10-year mortality shows that significant predictors of mortality are age [Hazard Ratio (HR) 1.04; 95% confidence interval (CI) 1.07-1.06; p = 0.001] and perioperative stroke (HR 2.30; 95% CI 1.18-4.50; p = 0.024). Neither stratified heart rate around the time of surgery nor beta-blocker use at the time of discharge was significant. There is no association between stratified heart rate in the perioperative period with long-term outcomes after repair of type A acute aortic dissection. These findings need clarification with further clinical trials.

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Figures

Fig. 1
Fig. 1
Patients included in the study, and the schema for classification into study Groups A, B, C and D, stratified by heart rate (bpm-beats per minute)
Fig. 2
Fig. 2
Kaplan–Meier curves for overall 10-year survival in patients with type A acute aortic dissection, stratified by heart rate
Fig. 3
Fig. 3
Kaplan–Meier curves for 10-year aortic event-free survival in patients with type A acute aortic dissection, stratified by heart rate
See this image and copyright information in PMC

References

    1. Bekkers JA, Bol Raap G, Takkenberg JJ, Bogers AJ. Acute type A aortic dissection: long-term results and reoperations. Eur J Cardiothorac Surg. 2013;43(2):389–396. doi: 10.1093/ejcts/ezs342. - DOI - PubMed
    1. Gariboldi V, Grisoli D, Kerbaul F, Giorgi R, Riberi A, Metras D, Mesana TG, Collart F. Long-term outcomes after repaired acute type A aortic dissections. Interact CardioVasc Thorac Surg. 2007;6(1):47–51. doi: 10.1510/icvts.2006.136606. - DOI - PubMed
    1. Melby SJ, Zierer A, Damiano RJ, Jr, Moon MR. Importance of blood pressure control after repair of acute type a aortic dissection: 25-year follow-up in 252 patients. J Clin Hypertens (Greenwich) 2013;15(1):63–68. doi: 10.1111/jch.12024. - DOI - PMC - PubMed
    1. Stevens LM, Madsen JC, Isselbacher EM, Khairy P, MacGillivray TE, Hilgenberg AD, Agnihotri AK (2009) Surgical management and long-term outcomes for acute ascending aortic dissection. J Thorac Cardiovasc Surg 138(6):1349–1357 e1341 - PubMed
    1. Tan ME, Morshuis WJ, Dossche KM, Kelder JC, Waanders FG, Schepens MA. Long-term results after 27 years of surgical treatment of acute type a aortic dissection. Ann Thorac Surg. 2005;80(2):523–529. doi: 10.1016/j.athoracsur.2005.02.059. - DOI - PubMed

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