Objective: Identify clinical factors associated with Myocardial injury after noncardiac surgery (MINS) in adults undergoing major vascular surgery including age, frailty, left ventricular diastolic dysfunction (LVDD), and comorbidities. Secondarily, describe the demographic and clinical characteristics of patients with MyoVista™‑detected LVDD and its association with postoperative outcomes.
Methods: In this single‑centre prospective cohort (n=44), adults undergoing elective or urgent vascular surgery had preoperative LVDD assessed by MyoVista™ (sensitivity 80%, specificity 84% vs. echocardiography). High‑sensitivity cardiac troponin (hs‑cTnT; ng/L) was measured preoperatively and on postoperative day 1. Frailty was defined as a Rockwood Clinical Frailty Scale ≥4. Patients were followed for 30 days to evaluate the incidence of MINS and secondary outcomes, including major adverse cardiovascular events (MACE), delirium, length of stay, discharge disposition, and mortality.
Results: MINS occurred in 9 patients (20%). MyoVista™-detected LVDD was more frequent among patients with MINS (89% vs. 46%, p = 0.027). MINS was associated with older age (median 79 with MINS vs. 69 years no MINS; p = 0.046). However, frailty (CFS ≥4), cardiac disease (44% vs. 77%; p=0.098) and diabetes (22% vs. 43%; p = 0.445), were not significantly associated with MINS. Trends suggested longer length of stay and higher complication rates among patients with LVDD, although not statistically significantly.
Conclusions: Preoperative LVDD detected by MyoVista™ was significantly associated with MINS, offering additional risk stratification information beyond conventional clinical variables. These findings require validation in larger multicentre cohorts and prospective trials to determine whether targeted interventions for LVDD can reduce perioperative myocardial injury.