• Dorota Studzińska, Marcin Zaczek, Kamil Polok, Grzegorz Ciepiela, Maciej Chwała, and Wojciech Szczeklik.
• Pol. Arch. Med. Wewn. 2024 Nov 29.

IntroductionAbdominal aortic aneurysms (AAAs) and peripheral arterial and aortic diseases (PAAD) are associated with increased risk of myocardial injury after noncardiac surgery (MINS).ObjectivesTo evaluate whether preoperative transthoracic echocardiography (TTE) abnormalities are linked to MINS in patients undergoing open vascular surgeries involving the abdominal aorta due to AAA and / or PAAD.Patients And MethodsThis is a retrospective cohort that analyzed consecutive patients who underwent open abdominal aortic surgery due to infrarenal AAA and / or aortoiliac occlusive disease in a single tertiary center. In each patient, TTE was performed within 1-3 months before the surgery and at least two postoperative high-sensitive troponins were measured (on the first and the second postoperative day) as per the standard of care at the participating center.ResultsThe study group comprised 336 patients. The median age was 67 years, and 82.7% of patients were male. MINS was diagnosed in 122 (36.3%) patients. Multivariable analysis revealed that myocardial hypokinesis compared to normal contractility was associated with a higher risk of MINS (OR 3.23, 95% CI 1.30 to 8.03). A similar association was not found for left ventricular ejection fraction (OR 1.08, 95% CI 0.78 to 1.48), left ventricular septum hypertrophy (OR 1.58, 95% CI 0.91 to 2.75), increased left atrium surface (OR 0.95, 95% CI 0.54 to 1.70) and mitral insufficiency (OR 0.89, 95% CI 0.50 to 1.58).ConclusionsOur study suggests that routine preoperative TTE may have a low but possible value in the prediction of MINS among patients undergoing high-risk vascular surgery.

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