PMID- 24755103
OWN - NLM
STAT- MEDLINE
DCOM- 20150928
LR  - 20150108
IS  - 1873-734X (Electronic)
IS  - 1010-7940 (Linking)
VI  - 47
IP  - 2
DP  - 2015 Feb
TI  - Impact of right ventricular dysfunction on the outcome of heart failure patients 
      undergoing surgical ventricular reconstructiondagger.
PG  - 333-40; discussion 340
LID - 10.1093/ejcts/ezu152 [doi]
AB  - OBJECTIVES: The aim was to assess the impact of right ventricular dysfunction 
      (RVD) on the outcome of heart failure (HF) patients undergoing surgical 
      ventricular reconstruction (SVR). METHODS: A total of 324 patients (65 +/- 9 years) 
      with previous myocardial infarction had an echocardiographic assessment of right 
      ventricular (RV) function before and after SVR. RV function was assessed 
      measuring the tricuspid annular plane systolic excursion (TAPSE) and RV 
      dysfunction was defined by a TAPSE < 16 mm. RESULTS: RV dysfunction was detected 
      in 69 patients (Group A, mean age 64 +/- 11 years), while 255 patients (Group B, 
      mean age 65 +/- 9 years) had a preserved RV function. Patients in Group A showed a 
      higher New York Heart Association (NYHA) class (P = 0.01), larger left 
      ventricular (LV) end-diastolic and end-systolic volumes (P = 0.01), a lower EF (P 
      = 0.01), a higher percentage of moderate-to-severe mitral regurgitation (P = 
      0.01) and a higher systolic pulmonary artery pressure (PAPs; P = 0.01). 
      Propensity score matching was applied in order to adjust for baseline 
      differences. In the fully matched population, low-output syndrome (P = 0.01), 
      inotropic support (P = 0.01) and intra-aortic balloon pump insertion (P = 0.03) 
      were significantly more frequent in Group A compared with Group B. However, 
      30-day mortality was not significantly different between the two groups (P = 
      0.18). Kaplan-Meier 5- and 8-year survival rate (log-rank: P = 0.01) as well as 
      freedom from cardiac events (log-rank: P = 0.02) were significantly lower in 
      patients with RV dysfunction. At Cox regression analysis, preoperative RVD (P = 
      0.01) and NYHA class at admission >II (P = 0.02) resulted in independent 
      predictor of late mortality. CONCLUSIONS: RV dysfunction correlates with LV 
      dysfunction and it is an important predictor of long-term outcome in HF patients 
      undergoing SVR.
CI  - (c) The Author 2014. Published by Oxford University Press on behalf of the European 
      Association for Cardio-Thoracic Surgery. All rights reserved.
FAU - Garatti, Andrea
AU  - Garatti A
AD  - Department of Cardiac Surgery, I.R.C.C.S. Policlinico San Donato, Milan, Italy 
      agaratti@tiscali.it.
FAU - Castelvecchio, Serenella
AU  - Castelvecchio S
AD  - Department of Cardiac Surgery, I.R.C.C.S. Policlinico San Donato, Milan, Italy.
FAU - Di Mauro, Michele
AU  - Di Mauro M
AD  - Department of Cardiovascular Disease, L'Aquila University, L'Aquila, Italy.
FAU - Bandera, Francesco
AU  - Bandera F
AD  - Heart Failure Unit, I.R.C.C.S. Policlinico San Donato, Milan, Italy.
FAU - Guazzi, Marco
AU  - Guazzi M
AD  - Heart Failure Unit, I.R.C.C.S. Policlinico San Donato, Milan, Italy.
FAU - Menicanti, Lorenzo
AU  - Menicanti L
AD  - Department of Cardiac Surgery, I.R.C.C.S. Policlinico San Donato, Milan, Italy.
LA  - eng
PT  - Journal Article
DEP - 20140421
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
MH  - Aged
MH  - Cardiac Surgical Procedures/adverse effects/methods/*mortality
MH  - Case-Control Studies
MH  - Electrocardiography
MH  - Female
MH  - Heart Failure/*surgery
MH  - Heart Ventricles/*surgery
MH  - Humans
MH  - Hypertension, Pulmonary
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Right/*mortality
OTO - NOTNLM
OT  - Heart failure
OT  - Right ventricular dysfunction
OT  - Surgical ventricular reconstruction
OT  - pulmonary hypertension
EDAT- 2014/04/24 06:00
MHDA- 2015/09/29 06:00
CRDT- 2014/04/24 06:00
PHST- 2014/04/24 06:00 [entrez]
PHST- 2014/04/24 06:00 [pubmed]
PHST- 2015/09/29 06:00 [medline]
AID - ezu152 [pii]
AID - 10.1093/ejcts/ezu152 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2015 Feb;47(2):333-40; discussion 340. doi: 
      10.1093/ejcts/ezu152. Epub 2014 Apr 21.