Loading...
Please wait, while we are loading the content...
Similar Documents
A systemic congestive index (systemic pulse pressure to central venous pressure ratio) predicts adverse outcomes in patients undergoing valvular heart surgery.
| Content Provider | Europe PMC |
|---|---|
| Author | Knio, Ziyad O. Morales, Frances L. Shah, Kajal P. Ondigi, Olivia K. Selinski, Christian E. Baldeo, Cherisse M. Zhuo, David X. Bilchick, Kenneth C. Mehta, Nishaki K. Kwon, Younghoon Breathett, Khadijah Thiele, Robert H. Hulse, Matthew C. Mazimba, Sula |
| Abstract | AbstractBackground and AimsInvasive hemodynamics may provide a more nuanced assessment of cardiac function and risk phenotyping in patients undergoing cardiac surgery. The systemic pulse pressure (SPP) to central venous pressure (CVP) ratio represents an integrated index of right and left ventricular function and thus may demonstrate an association with valvular heart surgery outcomes. This study hypothesized that a low SPP/CVP ratio would be associated with mortality in valvular surgery patients.MethodsThis retrospective cohort study examined adult valvular surgery patients with preoperative right heart catheterization from 2007 through 2016 at a single tertiary medical center (n = 215). Associations between the SPP/CVP ratio and mortality were investigated with univariate and multivariate analyses.ResultsAmong 215 patients (age 69.7 ± 12.4 years; 55.8% male), 61 died (28.4%) over a median follow‐up of 5.9 years. A SPP/CVP ratio <7.6 was associated with increased mortality (relative risk 1.70, 95% confidence interval [CI] 1.08–2.67, p = .019) and increased length of stay (11.56 ± 13.73 days vs. 7.93 ± 4.92 days, p = .016). It remained an independent predictor of mortality (adjusted odds ratio 3.99, 95% CI 1.47–11.45, p = .008) after adjusting for CVP, mean pulmonary artery pressure, aortic stenosis, tricuspid regurgitation, smoking status, diabetes mellitus, dialysis, and cross‐clamp time.ConclusionsA low SPP/CVP ratio was associated with worse outcomes in patients undergoing valvular heart surgery. This metric has potential utility in preoperative risk stratification to guide patient selection, prognosis, and surgical outcomes. |
| Related Links | https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC9543661&blobtype=pdf |
| Page Count | 8 |
| ISSN | 08860440 |
| Journal | Journal of Cardiac Surgery [J Card Surg] |
| Volume Number | 37 |
| DOI | 10.1111/jocs.16772 |
| PubMed Central reference number | PMC9543661 |
| Issue Number | 10 |
| PubMed reference number | 35842813 |
| e-ISSN | 15408191 |
| Language | English |
| Publisher | John Wiley and Sons Inc. |
| Publisher Date | 2022-07-17 |
| Publisher Place | Hoboken |
| Access Restriction | Open |
| Rights License | This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. © 2022 The Authors. Journal of Cardiac Surgery published by Wiley Periodicals LLC. |
| Subject Keyword | heart failure hemodynamic monitoring perioperative mortality pulmonary hypertension valvular surgery ventricular dysfunction |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pulmonary and Respiratory Medicine Surgery Cardiology and Cardiovascular Medicine |
