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- Title
Right ventricular assessment can improve prognostic value of Euroscore II.
- Authors
Di Mauro, Michele; Scrofani, Roberto; Antona, Carlo; Nicolò, Francesca; Cappabianca, Giangiuseppe; Beghi, Cesare; Santarpino, Giuseppe; Gregorini, Renato; Di Marco, Luca; Pacini, Davide; Salsano, Antonio; Santini, Francesco; Weltert, Luca; De Paulis, Ruggero; Pano, Marco; Zaccaria, Salvatore; D'Alfonso, Alessandro; Di Eusanio, Marco; Massi, Francesco; Portoghese, Michele
- Abstract
<bold>Background: </bold>The aim of this multicenter prospective study was to evaluate the prognostic weight of preoperative right ventricular assessment on early mortality in cardiac surgery.<bold>Methods: </bold>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.<bold>Conclusions: </bold>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.
- Subjects
HOSPITAL mortality; CARDIAC surgery; LONGITUDINAL method; CARDIAC research; RESEARCH teams; EXPERIMENTAL design; RELATIVE medical risk; RESEARCH; RIGHT heart ventricle; PATHOLOGICAL anatomy; PREOPERATIVE period; RESEARCH methodology; PROGNOSIS; EVALUATION research; MEDICAL cooperation; HEART ventricles; COMPARATIVE studies; RIGHT ventricular dysfunction; HEART physiology
- Publication
Journal of Cardiac Surgery, 2020, Vol 35, Issue 7, p1548
- ISSN
0886-0440
- Publication type
journal article
- DOI
10.1111/jocs.14672