A systemic congestive index (systemic pulse pressure to central venous pressure ratio) predicts adverse outcomes in patients undergoing valvular heart surgery.
A systemic congestive index (systemic pulse pressure to central venous pressure ratio) predicts adverse outcomes in patients undergoing valvular heart surgery.
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DOI：
10.1111/jocs.16772
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发表时间：
2022-10
影响因子：
1.6
通讯作者：
Mazimba, Sula
中科院分区：
文献类型：
--
作者：
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
关键词：
有创血流动力学可能对心脏手术患者的心功能和风险表型提供更细致的评估。全身脉压（SPP）与中心静脉压（CVP）的比值是右心室和左心室功能的综合指标，因此可能与心脏瓣膜手术的结果相关。本研究假设低SPP/CVP比值与心脏瓣膜手术患者的死亡率相关。
这项回顾性队列研究对2007年至2016年在一家三级医疗中心接受术前右心导管检查的成年心脏瓣膜手术患者进行了研究（n = 215）。通过单变量和多变量分析研究了SPP/CVP比值与死亡率之间的关联。
在215名患者（年龄69.7 ± 12.4岁；55.8%为男性）中，中位随访5.9年期间有61人死亡（28.4%）。SPP/CVP比值<7.6与死亡率增加（相对风险1.70，95%置信区间[CI] 1.08 - 2.67，p = 0.019）以及住院时间延长（11.56 ± 13.73天对比7.93 ± 4.92天，p = 0.016）相关。在对CVP、平均肺动脉压、主动脉狭窄、三尖瓣反流、吸烟状况、糖尿病、透析和阻断时间进行调整后，它仍然是死亡率的独立预测因子（调整后的比值比3.99，95% CI 1.47 - 11.45，p = 0.008）。
低SPP/CVP比值与心脏瓣膜手术患者较差的预后相关。这一指标在术前风险分层中具有潜在的应用价值，可用于指导患者选择、预后判断以及手术结果评估。
Invasive 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. This 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. Among 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. A 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.
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影响因子：
5.7
作者：
Oudiz, Ronald J.
通讯作者：
Oudiz, Ronald J.
DOI：
10.1136/amiajnl-2012-000929
发表时间：
2013-05-01
影响因子：
6.4
作者：
Maslove, David M.;Podchiyska, Tanya;Lowe, Henry J.
通讯作者：
Lowe, Henry J.
影响因子：
3
作者：
Petrie, Colin J.;Damman, Kevin;Voors, Adriaan A.
通讯作者：
Voors, Adriaan A.
影响因子：
8.3
作者：
Stergiopulos, N;Westerhof, N
通讯作者：
Westerhof, N
影响因子：
2.8
作者：
HUGENHOLTZ, PG;RYAN, TJ;STEIN, SW
通讯作者：
STEIN, SW