Table 2.
Baseline intraoperative echocardiographic and hemodynamic parameters and perioperative variables in hyperinsulinemic normoglycemic clamp (HNC) and standard therapy groups in patients with aortic stenosis (N=97).
| Variable | N | HNC (N = 49) | N | Standard (N = 48) | STD |
|---|---|---|---|---|---|
| Primary echocardiographic measurements | |||||
| LV systolic strain (%) | 43 | −17.0 ± 4.0 | 43 | −17.1 ± 3.1 | 0.03 |
| LV systolic strain rate (sec−1) | 42 | −0.8 ± 0.2 | 42 | −0.8 ± 0.2 | 0.16 |
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| Secondary intraoperative echocardiographic measurements | |||||
| RV systolic strain (%) | 32 | −21.0 ± 5.0 | 34 | −23.1 ± 3.6 | 0.48 |
| RV systolic strain rate (sec−1) | 32 | −1.0 ± 0.2 | 36 | −1.2 ± 0.3 | 0.59 |
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| |||||
| Additional intraoperative echocardiographic measurements | |||||
| LV ejection fraction (%) | 46 | 59 ± 15 | 45 | 64 ± 9 | −0.45 |
| Mitral lateral annular s′ velocity (cm/sec) | 48 | 4 ± 2 | 45 | 5 ± 2 | 0.30 |
| Mitral lateral annular e′ velocity (cm/sec) | 48 | 5 ± 2 | 45 | 6 ± 2 | −0.33 |
| Mitral lateral annular a′ velocity (cm/sec) | 47 | 5 ± 2 | 45 | 5 ± 2 | 0.10 |
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| |||||
| Hemodynamic parameters | |||||
| Mean arterial pressure (mmHg) | 49 | 86 ± 11 | 47 | 82 ± 11 | 0.35 |
| Central venous pressure (mmHg) | 48 | 16 ± 5 | 46 | 14 ± 6 | 0.31 |
| Cardiac output (L/min) | 31 | 4.3 ± 1.2 | 32 | 3.9 ± 0.7 | 0.36 |
| Cardiac index (L/min/m2) | 31 | 2.1 ± 0.5 | 32 | 2.0 ± 0.4 | 0.17 |
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| Intraoperative data | |||||
| Baseline glucose concentration (mg/dL) | 49 | 123.5 ± 37.3 | 48 | 119.0 ± 31.4 | 0.13 |
| Glucose concentration following release of aortic cross-clamp (mg/dL) | 49 | 144.6 ± 43.2 | 47 | 201.7 ± 71.2 | −0.97 |
| Intraoperative time-weighted mean glucose concentration (mg/dL) | 49 | 127 ± 19 | 48 | 177 ± 41 | −1.57 |
| Total insulin dose (units) | 48 | 115 ± 50 | 43 | 22 ± 25 | 2.4 |
| Hypoglycemia (≤40 mg/dL) | 49 | 0 (0) | 48 | 0 (0) | 0 |
| Fentanyl dose (mg) | 48 | 1.0 ± 0.2 | 48 | 1.0 ± 0.2 | −0.14 |
| End-tidal isoflurane concentration (%) | 35 | 1.3 ± 0.5 | 34 | 1.4 ± 0.5 | −0.16 |
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| Surgical characteristics | |||||
| Duration of surgery (min) | 49 | 359 [325, 412] | 48 | 373 [316, 440] | −0.02 |
| Duration of cardiopulmonary bypass (min) | 49 | 89 [65, 113] | 48 | 86 [64, 118] | 0.03 |
| Aortic cross-clamp (min) | 49 | 69 [48, 77] | 48 | 61 [49, 83] | 0.06 |
| Surgical procedure, N(%) | 49 | 48 | 0.16 | ||
| AVR | 26 (53) | 24 (50) | |||
| AVR + CABG | 13(27) | 16 (33) | |||
| AVR ± CABG + other procedures | 10 (20) | 8 (17) | |||
| Tricuspid valve repair | 0 (0) | 1 (2) | |||
| Maze procedure | 1 (2) | 1 (2) | |||
| Aortoplasty | 1 (2) | 3 (6) | |||
| Ascending aorta replacement | 3 (6) | 3 (6) | |||
| Mitral valve replacement | 1 (2) | 0 (0) | |||
| Mitral valve repair | 2 (4) | 0 (0) | |||
| Septal myectomy | 1 (2) | 0 (0) | |||
| Previous cardiac surgery, N(%) | 49 | 13 (27) | 48 | 10 (21) | 0.13 |
| Surgical incision, N(%) | 48 | 48 | 0.18 | ||
| Full-stemotomy | 34 (71) | 30 (63) | |||
| Mini-stemotomy | 15 (29) | 18 (37) | |||
| Cardioplegia, N(%) | 49 | 47 | 0.28 | ||
| Buckbergs | 43 (88) | 39 (83) | |||
| Del Nido | 5 (10) | 8 (17) | |||
| Microplegia | 1 (2) | 0 (0) | |||
Data are presented as mean ±SD, median [quartiles], or N(%); LV= left ventricle; RV = right ventricle; AVR = aortic valve replacement; CABG= coronary artery bypass grafting; STD=standardized difference: difference in means/proportions divided by the pooled standard deviation; absolute STD ≥0.40 considered as imbalanced.