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Right Ventricular Longitudinal Strain Predicts Low-Cardiac- Output Syndrome After Surgical Aortic Valve Replacement in Patients With Preserved and Mid-range Ejection Fraction.
- Source :
-
Journal of cardiothoracic and vascular anesthesia [J Cardiothorac Vasc Anesth] 2021 Jun; Vol. 35 (6), pp. 1638-1645. Date of Electronic Publication: 2020 Dec 08. - Publication Year :
- 2021
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Abstract
- Objectives: The aim of this study was to analyze whether right ventricular free wall longitudinal strain (RVFWSL) could be a predictor of low-cardiac-output syndrome (LCOS) after surgical aortic valve replacement (SAVR) in patients with left ventricular ejection fraction ≥40%.<br />Design: Prospective, observational study.<br />Setting: The study was conducted at a third level university hospital.<br />Participants: The study comprised 75 patients with severe aortic stenosis and LVEF ≥40% who underwent SAVR. The primary outcome was the occurrence of LCOS, and secondary outcomes were in-hospital mortality, hospital stay, or vasoplegic syndrome.<br />Interventions: Patients were divided into two groups (LCOS and no LCOS), and RVFWSL was analyzed to determine whether it is a predictor for LCOS. In addition, a receiver operating characteristic curve also was constructed, and the best cutoff value to predict LCOS was found. Furthermore, the reproducibility of RVFWSL measurements was evaluated.<br />Measurement and Main Results: The incidence of LCOS was 20% in the present study's cohort. After multivariate analysis, cross-clamp time (odds ratio 1.06, 95% confidence interval 1.02-1.11; p = 0.002) and RVFWSL (odds ratio 1.41, 95% confidence interval 1.07-1.87; p = 0.015) were the only predictors of LCOS. However, RVFWSL did not show association with secondary outcomes (p > 0.05 for all). The area under the curve of RVFWSL to predict LCOS was 0.75, and the best cutoff value was -17.3%, with a sensitivity of 86.7% and specificity of 61.7%.<br />Conclusions: RVFWSL seems to be a predictor of LCOS in patients with severe aortic stenosis and LVEF ≥40% undergoing SAVR. RVFWSL less than -17.3% may identify patients at increased risk for LCOS.<br /> (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Subjects :
- Aortic Valve diagnostic imaging
Aortic Valve surgery
Humans
Prospective Studies
Reproducibility of Results
Risk Factors
Stroke Volume
Treatment Outcome
Ventricular Function, Left
Aortic Valve Stenosis diagnostic imaging
Aortic Valve Stenosis surgery
Heart Valve Prosthesis Implantation adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1532-8422
- Volume :
- 35
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Journal of cardiothoracic and vascular anesthesia
- Publication Type :
- Academic Journal
- Accession number :
- 33419684
- Full Text :
- https://doi.org/10.1053/j.jvca.2020.12.008