Low left atrial volume is an independent predictor of persistent hypotension after carotid artery stenting
© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ..
BACKGROUND: Persistent hypotension (PH) after carotid artery stenting (CAS) is a relatively common complication; however, it is unclear which patients are more likely to experience this phenomenon. Recently, lower left atrial (LA) volume was associated with vasovagal syncope, which has a similar neurological mechanism to hypotension after CAS. This study aimed to investigate whether LA volume can predict PH after CAS.
METHODS: This single center retrospective analysis used data from 316 patients who had undergone CAS between March 2013 and February 2021. After the exclusion of urgent CAS, 212 procedures (202 patients) with transthoracic echocardiograms were included. The procedures were divided among two groups according to the presence or absence of PH for more than 1 hour after CAS.
RESULTS: The mean age of the patients was 73.0±7.5 years. PH was observed during 52 (24.5%) procedures. The PH group exhibited a lower LA volume index (LAVI) than the no-PH group (29.7±9.1 vs 37.7±12.5 mL/m2, respectively; p<0.001). The area under the receiver operating characteristic curve was 0.716. The optimal cut-off value was 33.5 mL/m2 (sensitivity 0.750, specificity 0.625). Multiple logistic regression analysis showed that LAVI <33.5 mL/m2 was an independent predictor for PH after CAS (OR 4.950, 95% CI 2.190 to 11.200; p<0.001). Preoperative hydration was negatively associated with PH (OR 0.235, 95% CI, 0.070 to 0.794; p=0.020).
CONCLUSIONS: A lower LA volume can predict PH after CAS, and preoperative hydration may prevent PH after CAS.
| Errataetall: |
ErratumIn: J Neurointerv Surg. 2023 Dec 19;16(1):e2. - PMID 38114329 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:15 |
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| Enthalten in: |
Journal of neurointerventional surgery - 15(2023), 9 vom: 31. Sept., Seite 914-918 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Maekawa, Kota [VerfasserIn] |
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| Links: |
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| Themen: |
Atherosclerosis |
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| Anmerkungen: |
Date Completed 21.08.2023 Date Revised 19.12.2023 published: Print-Electronic ErratumIn: J Neurointerv Surg. 2023 Dec 19;16(1):e2. - PMID 38114329 Citation Status MEDLINE |
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| doi: |
10.1136/jnis-2022-019094 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM344377261 |
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| 245 | 1 | 0 | |a Low left atrial volume is an independent predictor of persistent hypotension after carotid artery stenting |
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| 500 | |a ErratumIn: J Neurointerv Surg. 2023 Dec 19;16(1):e2. - PMID 38114329 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a BACKGROUND: Persistent hypotension (PH) after carotid artery stenting (CAS) is a relatively common complication; however, it is unclear which patients are more likely to experience this phenomenon. Recently, lower left atrial (LA) volume was associated with vasovagal syncope, which has a similar neurological mechanism to hypotension after CAS. This study aimed to investigate whether LA volume can predict PH after CAS | ||
| 520 | |a METHODS: This single center retrospective analysis used data from 316 patients who had undergone CAS between March 2013 and February 2021. After the exclusion of urgent CAS, 212 procedures (202 patients) with transthoracic echocardiograms were included. The procedures were divided among two groups according to the presence or absence of PH for more than 1 hour after CAS | ||
| 520 | |a RESULTS: The mean age of the patients was 73.0±7.5 years. PH was observed during 52 (24.5%) procedures. The PH group exhibited a lower LA volume index (LAVI) than the no-PH group (29.7±9.1 vs 37.7±12.5 mL/m2, respectively; p<0.001). The area under the receiver operating characteristic curve was 0.716. The optimal cut-off value was 33.5 mL/m2 (sensitivity 0.750, specificity 0.625). Multiple logistic regression analysis showed that LAVI <33.5 mL/m2 was an independent predictor for PH after CAS (OR 4.950, 95% CI 2.190 to 11.200; p<0.001). Preoperative hydration was negatively associated with PH (OR 0.235, 95% CI, 0.070 to 0.794; p=0.020) | ||
| 520 | |a CONCLUSIONS: A lower LA volume can predict PH after CAS, and preoperative hydration may prevent PH after CAS | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Atherosclerosis | |
| 650 | 4 | |a Blood Pressure | |
| 650 | 4 | |a Catheter | |
| 650 | 4 | |a Plaque | |
| 650 | 4 | |a Stent | |
| 700 | 1 | |a Ohara, Nobuyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Takasugi, Junji |e verfasserin |4 aut | |
| 700 | 1 | |a Fujiwara, Satoru |e verfasserin |4 aut | |
| 700 | 1 | |a Okada, Taiji |e verfasserin |4 aut | |
| 700 | 1 | |a Miyakoshi, Chisato |e verfasserin |4 aut | |
| 700 | 1 | |a Imamura, Hirotoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Kawamoto, Michi |e verfasserin |4 aut | |
| 700 | 1 | |a Sakai, Nobuyuki |e verfasserin |4 aut | |
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