Document Detail

Risk analysis of low cardiac output syndrome after valve replacement.
MedLine Citation:
PMID:  8122258     Owner:  NLM     Status:  MEDLINE    
In order to obtain a better understanding of the pathogenesis of the postoperative low cardiac output syndrome (LOS), a multivariate regression analysis was performed, evaluating predictive risk factors quantitatively as a function of plural preoperative variables. A total of 145 cases including 76 MVR (MS 36 MR 40), 42 AVR and 27 DVR were analyzed in this study. Ten historical, 10 hemodynamic and 4 operative risk factors were collected to compose the data file with corresponding status of postoperative cardiac function which was classified as follows. Patients who were not associated with postoperative LOS (Score 1), associated with the LOS which required and responded to ordinal dosage of a catecholamine (Score 2) associated with the LOS which required and responded to maximal dosage of the catecholamine and/or mechanical circulatory support (Score 3), and died of LOS (Score 4). Variables with significant relationships to postoperative LOS, regression equation to LOS score and their multiple correlation coefficients (R) of each group were as follows. MVR group: technical trouble (TT), extracorporeal circulation time (ECCT), change of myocardial preservation methods, delta LVSWI/delta LVEDP, diseased duration, aortic cross clamping time, CTR, Y = -1.16 + 1.01 (TT) + 0.05(ECCT) + 0.16(delta LVSWI/delta LVEDP) + 0.02(CTR), R = 0.76. AVR group: LVMMI, ECCT, cardiac failure, NYHA, Y = -0.71 + 0.03(LVMMI) + 0.004 (ECCT) + 0.22(NYHA), R = 0.78. DVR group: delta LVWI/delta LVEDP, LVMMI, NYHA, LV diastolic eccentricity ratio, ECCT, Y = -0.50 + 0.60 (delta LVWI/delta LVEDP) + 0.003(LVMMI) + 1.18(NYHA) + 0.38(delta LVSWI/delta LVEDP) + 0.003(ECCT), R = 0.87. It was demonstrated that preoperative ergometer exercise study during cardiac catheterization was useful in prediction of postoperative outcomes, especially in the MVR (MS) group.
N Sato; N Uchida; M Miura; M Ohmi; T Fukuju; K Tabayashi; K Haneda; H Mohri
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Tohoku journal of experimental medicine     Volume:  171     ISSN:  0040-8727     ISO Abbreviation:  Tohoku J. Exp. Med.     Publication Date:  1993 Sep 
Date Detail:
Created Date:  1994-04-07     Completed Date:  1994-04-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0417355     Medline TA:  Tohoku J Exp Med     Country:  JAPAN    
Other Details:
Languages:  eng     Pagination:  77-88     Citation Subset:  IM    
Department of Thoracic and Cardiovascular Surgery, Tohoku University School of Medicine, Sendai.
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MeSH Terms
Cardiac Output, Low / etiology*,  physiopathology
Exercise Test
Heart Valve Prosthesis / adverse effects*
Hemodynamics / physiology
Multivariate Analysis
Regression Analysis
Risk Factors
Treatment Outcome

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