A Prospective Study to Assess the Impact of Diastolic Dysfunction on Post-Operative Outcomes after Coronary Artery Bypass Graft Surgery

Objectives: In cardiac surgery, diastolic dysfunction (DD) is becoming a more widely acknowledged factor of unfavorable post-operative outcomes. The objective of the prospective study was to assess how DD affected the early post-operative course in patients undergoing elective coronary artery bypass graft (CABG) surgery. Material and Methods: This single-center prospective observational study included 75 patients who underwent elective CABG. Diastolic function (DF) was assessed preoperatively using transesophageal echocardiography, based on a simplified algorithm, with supplementary parameters including tricuspid regurgitation jet velocity and medial e’ velocity. Patients were categorized into normal and abnormal DF groups, and various intraoperative and post-operative parameters were recorded and compared. Results: Out of 75 patients, 59 (78.67%) had abnormal DF. These patients were significantly older (mean age 64.47 ± 7.67 years) compared to those with normal function (55.56 ± 7.02 years, P < 0.001). Echocardiographic parameters, including septal e’, lateral e’, average e’, and E/e’ ratio, showed significant impairment in the abnormal DF group ( P < 0.001). Prolonged intubation time (16.84 ± 2.98 vs. 6.07 ± 1.23 h), higher vasoactive-inotropic scores (5.87 ± 4.68 vs. 2.40 ± 2.32), and prolonged intensive care unit stay (3.37 ± 1.48 vs. 2.06 ± 0.56 days) were found in DF patients ( P < 0.001). Complications such as pleural effusion and atrial fibrillation were more common in the abnormal DF group. Conclusion: DD is prevalent among CABG patients and associated with adverse post-operative outcomes, including prolonged intubation, higher inotropic support, and increased complications. Routine pre-operative assessment of DF can help identify high-risk patients and tailor perioperative management.