Effect of Diastolic Dysfunction on Early Outcomes During Elective Off-Pump Coronary Artery Bypass Grafting: A Prospective Observational Study

Background Left ventricular diastolic dysfunction (DD) causes adverse outcomes after cardiac surgery; however, the effects of DD during off-pump coronary artery bypass grafting (OPCAB) are not well understood. We aimed to assess the influence of DD on early mortality and morbidity of patients undergoing OPCAB. Methods This prospective observational study included 1,256 patients scheduled for elective OPCAB. The DD of the patients was assessed by transthoracic echocardiography and tissue Doppler imaging. The cohort was classified into four DD groups; normal, mild (relaxation abnormality), moderate (pseudonormal dysfunction), and severe (restrictive abnormality). Study endpoints were major adverse cardiac events and other complications. Multivariate logistic regression was used to evaluate the independent effect of DD on surgical outcomes. Results The 1,256 patients were grouped as follows: normal diastolic function (n = 55, 4.4%), mild DD (n = 995, 79.2%), moderate DD (n = 169, 13.5%), and severe DD (n = 37, 2.9%). Operative strategy did not differ among groups. The prevalence of hypertension, diabetes mellitus, renal failure, low ejection fraction (