Right ventricular myocardial performance index predicts perioperative mortality or circulatory failure in high-risk valvular surgery
Right ventricular myocardial performance index predicts perioperative mortality or circulatory failure in high-risk valvular surgery
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DOI：
10.1016/j.echo.2007.02.017
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发表时间：
2007-09-01
影响因子：
6.5
通讯作者：
Tardif, Jean-Claude
中科院分区：
文献类型：
--
作者：
Haddad, Francois;Denault, Andre Y.;Tardif, Jean-Claude
背景。右心室心肌功能指数（RVMPI）和右心室分数面积变化（RVFAC）在二尖瓣或主动脉瓣手术中的预后价值尚未得到很好的描述。本研究的主要目的是评估RVMPI和RVFAC在预测术后死亡率或循环衰竭方面的预后价值。方法：对50例连续行二尖瓣或主动脉瓣矫正手术的患者，采用经食管超声心动图前瞻性测量麻醉诱导后RVMPI和RVFAC。对住院死亡率或循环衰竭的主要临床终点进行单因素和多因素分析。结果：研究人群平均年龄为67±9岁。主要终点发生在17例患者（34%）；3名患者死亡，14名患者出现循环衰竭的迹象。多因素回归分析发现RVMPI和RVFAC是影响预后的变量。结论：术前RVMPI和RVFAC在预测心脏瓣膜手术术后死亡率和发病率方面具有递增价值。未来的研究需要在更大的人群中验证这些结果。
Background. The prognostic value of right ventricular myocardial performance index (RVMPI) and right ventricular fractional area change (RVFAC) in mitral or aortic valve surgery has not been well described. The main objective of this study is to assess the prognostic value of RVMPI and RVFAC in predicting postoperative mortality or circulatory failure.Methods: RVMPI and RVFAC were prospectively measured after induction of anesthesia using transesophageal echocardiography in 50 consecutive patients undergoing corrective mitral or aortic valve surgery. Univariate and multivariate analyses were performed for the primary clinical end point of in-hospital mortality or circulatory failure.Results: in the study population, the mean age was 67 +/- 9 years. The primary end point occurred in 17 patients (34%); three patients died, and 14 patients presented signs of circulatory failure. Multivariate regression analysis identified RVMPI and RVFAC as variables of prognostic significance.Conclusion: Preoperative RVMPI and RVFAC could have an incremental value in predicting postoperative mortality and morbidity in valvular heart surgery. Future studies are needed to validate these results in a larger population.