• Su-Kiat Chua, Kou-Gi Shyu, Ming-Jen Lu, Huei-Fong Hung, Jun-Jack Cheng, Shih-Huang Lee, Chia-Hsun Lin, Hung-Hsing Chao, and Huey-Ming Lo.
• Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University.
• Circ. J. 2013 Jan 1; 77 (9): 2303-10.

BackgroundRenal dysfunction is associated with a higher rate of atrial fibrillation in clinical practice. This study investigated the associations between renal function, left ventricular (LV) diastolic dysfunction, and postoperative atrial fibrillation (POAF).Methods And ResultsA total of 265 consecutive patients who underwent cardiac surgery were prospectively enrolled in the study. Echocardiography was performed before cardiac surgery. The patients were divided into 3 groups based on estimated glomerular filtration rate (eGFR) (group 1, ≥90ml·min(-1)·1.73m(-2); group 2, 60-90ml·min(-1)·1.73m(-2); and group 3, <60ml·min(-1)·1.73m(-2)). POAF occurred in 83 of 265 patients (31.3%). The rate of new-onset POAF increased from 15.2% (12/79) in group 1 to 27.8% (27/97) in group 2 and 49.4% (44/89) in group 3 (P<0.001). Further, with increasing renal dysfunction from groups 1 to 3, the rate of LV diastolic dysfunction - defined as E/e' >15 - also increased (group 1, 19.0%; group 2, 38.1%; and group 3, 48.3%; P<0.001). Absolute eGFR was significantly correlated with E/e' ratio (r=-0.39, P<0.001). Renal function remained as the independent predictor of POAF on multivariate analysis (odds ratio, 1.90; 95% confidence interval: 1.26-2.87; P=0.002).ConclusionsIn patients undergoing cardiac surgery, decreased eGFR was associated with an increased rate of LV diastolic dysfunction with a subsequent increase in the rate of POAF.

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