• M Zawadka, M Marchel, P Dudek, P Andruszkiewicz, T Jakimowicz, A Gąsecka, M Kutka, and J Poelaert.
• 2nd Department of Anesthesiology and Intensive Care Medical University of Warsaw, Warsaw, Poland; Perioperative Medicine, Barts Heart Centre and St. Bartholomew's Hospital, London, UK; Polish National Agency for Academic Exchange, Warsaw, Poland.
• J. Cardiothorac. Vasc. Anesth. 2021 Aug 1; 35 (8): 2345-2354.

ObjectivesThe purpose of this study was to determine the relationship between the changes in diastolic function and their association with cardiac biomarkers in the perioperative period in patients undergoing complex endovascular aortic repair.DesignProspective observational study.SettingSingle-center academic hospital, central teaching hospital in Warsaw, Poland.ParticipantsThe study comprised 27 high-risk patients scheduled for elective endovascular repair of aortic aneurysm.InterventionsComplex endovascular procedure using branched endograft of the thoracoabdominal aorta. Branches of the stent grafts included renal arteries, the superior mesenteric artery, and the celiac trunk.Measurements And Main ResultsThe primary outcome was to evaluate changes in diastolic function parameters assessed with transthoracic echocardiography at two and 24 hours postoperatively. The major secondary outcomes were changes in N-terminal pro-B-type natriuretic peptide (NT-proBNP) and troponin I concentrations, systolic function parameters, hemodynamic parameters at two and 24 hours, length of hospital stay, and 30-day mortality. There was a reduction in e' wave velocity on both the septal and lateral sides at two hours compared with the baseline (p = 0.041 and p = 0.05, respectively). There was an increase in both NT-proBNP and troponin I concentrations after surgery (p = 0.002 and p = 0.034, respectively), with troponin I peaking two hours after surgery and NT-proBNP peaking 24 hours after surgery.ConclusionsPatients undergoing a branched endovascular aortic repair of a thoracoabdominal aortic aneurysm experience a cardiac insult that manifests with deterioration in diastolic parameters and concomitant increases of troponin and NT-proBNP concentrations. Additional large-scale prospective studies are required to confirm this phenomenon.Copyright © 2020 Elsevier Inc. All rights reserved.

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