Right ventricular assessment can improve prognostic value of Euroscore II.

Tytuł:: Right ventricular assessment can improve prognostic value of Euroscore II.
Autorzy:: Di Mauro M; Cardio-Thoracic Surgery Unit, Heart and Vascular Centre, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre (MUMC), Maastricht, The Netherland.
Scrofani R; Department of Cardiac Surgery, 'Fatebenefratelli-Sacco' Hospital, University of Milan, Milan, Italy.
Antona C; Department of Cardiac Surgery, 'Fatebenefratelli-Sacco' Hospital, University of Milan, Milan, Italy.
Nicolò F; Department of Cardiac Surgery, 'Fatebenefratelli-Sacco' Hospital, University of Milan, Milan, Italy.
Cappabianca G; Division of Cardiac Surgery, U.O. Cardiochirurgia Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
Beghi C; Division of Cardiac Surgery, U.O. Cardiochirurgia Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
Santarpino G; Dipartimento di Cardiochirurgia, Città di Lecce Hospital-GVM Care & Research, Lecce, Italy.; Department of Cardiothoracic Surgery, Paracelsus Medical University, Nuremberg, Germany.
Gregorini R; Dipartimento di Cardiochirurgia, Città di Lecce Hospital-GVM Care & Research, Lecce, Italy.
Di Marco L; Cardiac Surgery Unit, Cardio-Thoracic-Vascular Deptartment, S.Orsola Hospital, University of Bologna, Bologna, Italy.
Pacini D; Cardiac Surgery Unit, Cardio-Thoracic-Vascular Deptartment, S.Orsola Hospital, University of Bologna, Bologna, Italy.
Salsano A; Department of Cardiac Surgery, IRCCS 'S. Martino' University of Genova, Genova, Italy.
Santini F; Department of Cardiac Surgery, IRCCS 'S. Martino' University of Genova, Genova, Italy.
Weltert L; Department of Cardiac Surgery, European Hospital, Rome, Italy.
De Paulis R; Department of Cardiac Surgery, European Hospital, Rome, Italy.
Pano M; Department of Cardiac Surgery, 'Vito Fazzi' Hospital, Lecce, Italy.
Zaccaria S; Department of Cardiac Surgery, 'Vito Fazzi' Hospital, Lecce, Italy.
D'Alfonso A; Department of Cardiac Surgery, Torrette-Riuniti Hospital, Ancona, Italy.
Di Eusanio M; Department of Cardiac Surgery, Torrette-Riuniti Hospital, Ancona, Italy.
Massi F; Department of Cardiac Surgery, AOU Sassari, Sassari, Italy.
Portoghese M; Department of Cardiac Surgery, AOU Sassari, Sassari, Italy.
Stura EC; Department of Cardiac Surgery, AOU 'Città della Salute e della Scienza' Hospital, Turin, Italy.
Rinaldi M; Department of Cardiac Surgery, AOU 'Città della Salute e della Scienza' Hospital, Turin, Italy.
Margari V; Dipartimento dell'Emergenza e Trapianti d'Organo, Sezione di Cardiochirurgia, Università di Bari Aldo Moro. Ospedale Santa Maria, GVM Care & Research, Bari, Italy.
Foschi M; Heart Department, SS Annunziata Hospital, Chieti, Italy.
Parolari A; UOC Cardiac Surgery and Translational Research, IRCCS San Donato and University of Milan, San Donato Milanese, Italy.
Paparella D; Dipartimento dell'Emergenza e Trapianti d'Organo, Sezione di Cardiochirurgia, Università di Bari Aldo Moro. Ospedale Santa Maria, GVM Care & Research, Bari, Italy.
Źródło:: Journal of cardiac surgery [J Card Surg] 2020 Jul; Vol. 35 (7), pp. 1548-1555. Date of Electronic Publication: 2020 Jun 03.
Typ publikacji:: Journal Article; Multicenter Study
Język:: English
Imprint Name(s):: Publication: Hoboken, NJ : Wiley-Blackwell
Original Publication: Mount Kisco, N.Y. : Futura Pub. Co., Inc., [c1986-
MeSH Terms:: Research Design*
Ventricular Function, Right*
Cardiac Surgical Procedures/*mortality
Heart Ventricles/*pathology
Outcome Assessment, Health Care/*methods
Adult ; Aged ; Aged, 80 and over ; Dilatation, Pathologic ; Female ; Humans ; Male ; Middle Aged ; Preoperative Period ; Prognosis ; Prospective Studies ; Risk ; Ventricular Dysfunction, Right ; Young Adult
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Contributed Indexing:: Keywords: Euroscore II; right ventricle; right ventricular dilatation; right ventricular dysfunction
Entry Date(s):: Date Created: 20200604 Date Completed: 20201102 Latest Revision: 20201102
Update Code:: 20240104
DOI:: 10.1111/jocs.14672
PMID:: 32490568
: Czasopismo naukowe

Pełny tekst

Background: The aim of this multicenter prospective study was to evaluate the prognostic weight of preoperative right ventricular assessment on early mortality in cardiac surgery.
Methods: This is a multicenter prospective observational study performed by the Italian Group of Research for Outcome in Cardiac Surgery (GIROC) including 11 centers. From October 2017 to March 2019, out of 923 patients undergoing cardiac surgery, 28 patients with some missing data were excluded and 895 patients were enrolled in the study right ventricular dilatation was defined as a basal end-diastolic diameter >42 mm. The right ventricle (RV) function was assessed using the combination of three parameters: fractional area changing (FAC), tricuspid annular plane systolic excursion (TAPSE), and S'-wave using tissue Doppler imaging (TDI-S'); RV dysfunction was defined as the presence of at least two of the following cutoffs: FAC <35%, TAPSE <17 mm, and TDI S' <9.5 mm RESULTS: Among the entire cohort, 624 (70%) showed normal RV, 92 (10%) isolated RV dilatation, 154 (17%) isolated RV dysfunction, and 25 (3%) both RV dilatation and dysfunction. Non-surviving patients showed a significantly higher rate of RV alteration at multivariable analysis, RV status was found to be an independent predictor for higher in-hospital mortality beside Euroscore II.
Conclusions: This prospective multicenter observation study shows the importance to assess RV preoperatively and to include both RV function and dimension in a risk score model such as Euroscore II to implement its predictivity, since PH cannot always mirror the status of the right ventricle.
(© 2020 Wiley Periodicals LLC.)

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