• Norikatsu Mita, Masataka Kuroda, Sohtaro Miyoshi, and Shigeru Saito.
• Department of Anesthesiology, Saitama Cardiovascular and Respiratory Center, Kumagaya City, Japan. Electronic address: mita.norikatsu@gmail.com.
• J. Cardiothorac. Vasc. Anesth. 2017 Apr 1; 31 (2): 464-473.

ObjectivesTo clarify the relationship between right and left ventricular (RV and LV) diastolic function and postoperative atrial fibrillation (POAF). The early effects of major lung surgery on cardiac function in the intraoperative period during lung surgery were evaluated, using transesophageal echocardiography.DesignSingle-center prospective observational study.SettingA public hospital.ParticipantsPatients undergoing elective lobectomy with lymph node dissection for lung cancer (n = 116).InterventionsTransesophageal echocardiography examination was performed under general anesthesia before skin incision (preoperative) and after chest closure (postoperative). According to measured echocardiographic variables, ventricular systolic and diastolic functions were classified at each time point.Measurements And Main ResultsOf the 116 patients, 24 (20.7%) experienced POAF. Preoperative RV and LV diastolic dysfunction were more common in patients with POAF than in those without POAF (58.3 v 28.3%, p = 0.008; 54.2 v 19.6%, p = 0.001, respectively). Among patients without preoperative diastolic dysfunction, a small number developed RV and LV diastolic dysfunction immediately after surgery (9.2% and 16.5%, respectively) and these distributions were comparable between patients with POAF and those without POAF. RV systolic dysfunction was observed in 6.5% of patients immediately after surgery and was not related to the occurrence of POAF. Multivariate analysis revealed older age, chronic obstructive pulmonary disease (COPD), and preoperative biventricular diastolic dysfunction as risk factors for POAF.ConclusionsPreoperative biventricular diastolic dysfunction, as well as older age and COPD, are associated with POAF in patients undergoing lobectomy. Major lung surgery has minimal early effects on postoperative systolic and diastolic functions.Copyright © 2017 Elsevier Inc. All rights reserved.

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