medigraphic.com
SPANISH

Revista Cubana de Cardiología y Cirugía Cardiovascular

ISSN 1561-2937 (Print)
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2015, Number 4

<< Back Next >>

Rev Cubana Cardiol Cir Cardiovasc 2015; 21 (4)

Association of left ventricular systolic dysfunction with subsequent cardiac events in coronary artery bypass surgery

Flores SA, Rodríguez MA, Castillo MMP, Chacón E, Paredes CÁM
Full text How to cite this article

Language: Spanish
References: 13
Page:
PDF size: 367.29 Kb.


Key words:

heart failure, systolic/surgery, left ventricular systolic dysfunction/contraindications, ventricular dysfunction, left/coronary artery bypass.

ABSTRACT

Background: Systolic heart failure is a prognostic factor for several adverse clinical situations.
Proposal: to determine if left ventricular systolic dysfunction is associated with cardiac events after coronary artery bypass surgery.
Method: a prospective, longitudinal and observational study with 130 revascularizated patients by coronary artery bypass surgery since the reopening of this activity at 2010 at the Cardiovascular Institut was done. Evolution of patients until 12 months after surgery was determined by external consults and phone calls. Population of the study was divided in two groups: with left ventricular ejection fraction more than 45% (119 patients) and less or equal of 45% (11 patients) for statystical. Chi square and t-student was used to compare qualitatives and quantitatives variables respectively. Probability of survival free of events was determined by Kaplan-Meier test and comparison between groups by Cox-Mantel test.
Results: previous myocardial infarction (p=0.02), higher endiastolic and endsytolic diameters(p=0.00) and higher creatinin levels were more frequent in the group of patients with ejection fraction less than 45%. There were differences between both groups according to the incidence of intra-hospital cardiac events (p=0.008) and cardiac mortality (p=0.03). Survival probability without cardiac events at 12 months was less in patients with ejection fraction less than 45%.
Conclusion: preoperative left ventricular systolic dysfunction is associated with a higher intra-hospital cardiac mortality.


REFERENCES

  1. Carson P, Wertheimer J, Miller A, O'Connor CM, Pina IL,Selzman C et al. Surgical treatment for Ischemic Heart Fail-ure (STICH) Trial: mode of death results. JACC Heart Fail. 2013 October [citado 9 Sept 2015]; 1(5). Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3829618/

  2. Phillips HR, O’Connor CM, Rogers J. Revascularization for heart failure. Am Heart J 2007; 2007 Apr [citado 9 Sept 2015];153 (4 Suppl):65-73. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/17394905.

  3. Panza JA, Velásquez EJ, She L, Smith PK, Nicolau JC, Favaloro RR et al. Extent of coronary and myocardial disease and benefit from surgical revascularization in LV dysfunction. J Am Coll Cardiol 2014[citado 9 Sept 2015]; 64:553–61.Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/25104523

  4. Bonow RO, Maurer G, Lee KL, Holly TH,Binkley PF,Desvine-Nickens P et al. Myocardial viability in ischemic left ventricular dysfunction. N Engl J Med 2011[citado 9 Sept 2015];364:1617-25. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3290901/

  5. Velázquez EJ, Bonow RO. Revascularization in severe left ven-tricular dysfunction. J Am Coll Cardiol 2015[citado9 Sept 2015];65:615–24. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/25677320

  6. Jessup M, Acker MA. Surgical Management of Heart Failure. En: Douglas L. Mann, Douglas P. Zipes, Peter Libby, Robert O. Bonow, Eugene Braunwald. Braunwald’s heart disease: a text-book of cardiovascular medicine. 10th ed. Philadelphia: Elsevier Saunders, 2015,p.575-588.

  7. Kress A. Renal failure following hospitalization for heart failure. Prof Case Manag 2015 Mar-Apr [citado9 Sept 2015];20(2):91-5. Disponible en:http://www.ncbi.nlm.nih.gov/pubmed/25647001

  8. Allman KC, Shaw LJ, Hachamovitch R, Udelson JE. Myocardial viability testing and impact of revascularization on prognosis in patients with coronary artery disease and left ventricular dys-function: a meta-analysis. J Am Coll Cardiol. 2002;39:1151-8.

  9. Bonow RO. Indications for revascularization in patients with left ventricular dysfunction: Evidence and uncertainties. J Thorac Cardiovasc Surg 2014;148:2461-5.

  10. Zishiri ET, Williams S, Cronin EM, Blackstone EH, Ellis SG, Roselli EE et al. Early Risk of Mortality After Coronary Artery Revascularization in Patients With Left Ventricular Dysfunction and Potential Role of the Wearable Cardioverter Defibrillator. Circ Arrhythm Electrophysiol. 2013[citado9 Sept 2015];6:117-128. Disponible en: http://circep.ahajournals.org/content/6/1/117.full.pdf+html

  11. Shahian DM, O’Brien SM, Sheng S, Grover FL, Mayer JE, Ja-cobs JP et al. Predictors of long-term survival after coronary ar-tery bypass grafting surgery: results from the Society of Tho-racic Surgeons Adult Cardiac Surgery Database (the ASCERT study). Circulation 2012[citado9 Sept 2015];125:1491–1500. Disponible en: http://circ.ahajournals.org/content/125/12/1491.full.pdf+html

  12. Nagendran J, Norris CM, Graham MM, Ross DB, Ross DB, MacArthur RG, Kieser TM et al. Coronary Revascularization for Patients with Severe Left Ventricular Dysfunction. Ann Thorac Surg 2013[citado9 Sept 2015]; 96:2038–44. Disponible en: http://www.annalsthoracicsurgery.org/article/S0003-4975%2813%2901380-5/pdf

  13. Phillips HR, O’Connor CM, Rogers J. Revascularization for heart failure. Am Heart J 2007; 153(4):565-573.




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Rev Cubana Cardiol Cir Cardiovasc. 2015;21