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Schneider H, Berliner D, Stockhoff L, Reincke M, Mauz JB, Meyer B, Bauersachs J, Wedemeyer H, Wacker F, Bettinger D, Hinrichs JB, Maasoumy B. Diastolic dysfunction is associated with cardiac decompensation after transjugular intrahepatic portosystemic shunt in patients with liver cirrhosis. United European Gastroenterol J 2023; 11:837-851. [PMID: 37897707 PMCID: PMC10637125 DOI: 10.1002/ueg2.12471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 07/21/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND AND AIMS About 20% of patients develop cardiac decompensation within the first year after transjugular intrahepatic portosystemic shunt (TIPS) insertion. However, risk factors for cardiac decompensation remain poorly defined. We aimed to evaluate predictors of cardiac decompensation after TIPS insertion in a large, well-defined cohort of patients with liver cirrhosis. METHODS 234 cirrhotic patients who received a TIPS at Hannover Medical School were retrospectively followed up for one year to assess the incidence of cardiac decompensation. Echocardiographic parameters and established diagnostic criteria for cardiac impairment (e.g. by the American Society of Echocardiography/ European Association of Cardiovascular Imaging (ASE/EACVI)) were investigated for an association with cardiac decompensation in a competing risk analysis. Survival was analyzed using a multivariable cox regression analysis adjusting for Freiburg index of post-TIPS survival. RESULTS Predominant TIPS indication was ascites (83%). Median age was 59 years, median MELD-score 12% and 58% were male. Overall, 41 patients (18%) developed cardiac decompensation within one year after TIPS insertion. Diastolic dysfunction according to the ASE/EACVI was diagnosed in 26% of patients at baseline and was linked to a significantly higher risk for cardiac decompensation (p = 0.025) after TIPS. When investigating individual echocardiographic baseline parameters, only pathological E/A (<0.8 or >2) was identified as a risk factor for cardiac decompensation (p = 0.015). Mortality and liver transplantation (n = 50) were significantly higher among patients who developed cardiac decompensation (HR = 5.29, p < 0.001) as well as in patients with a pathological E/A (HR = 2.34, p = 0.006). Cardiac high-risk status (44% of patients) was strongly linked to cardiac decompensation (HR = 2.93, p = 0.002) and mortality (HR = 2.24, p = 0.012). CONCLUSION Cardiac decompensation after TIPS is a frequent and important complication and is associated with reduced survival. American Society of Echocardiography/EACVI criteria and E/A seem to be the best parameters to predict the cardiac risk in cirrhotic patients undergoing TIPS insertion.
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Affiliation(s)
- Hannah Schneider
- Department of Gastroenterology, Hepatology, Infectious Diseases and EndocrinologyHannover Medical SchoolHannoverGermany
| | - Dominik Berliner
- Department of Cardiology and AngiologyHannover Medical SchoolHannoverGermany
| | - Lena Stockhoff
- Department of Gastroenterology, Hepatology, Infectious Diseases and EndocrinologyHannover Medical SchoolHannoverGermany
| | - Marlene Reincke
- Department of Medicine IIMedical Center University of FreiburgFreiburg im BreisgauGermany
| | - Jim B. Mauz
- Department of Gastroenterology, Hepatology, Infectious Diseases and EndocrinologyHannover Medical SchoolHannoverGermany
| | - Bernhard Meyer
- Department of Diagnostic and Interventional RadiologyHannover Medical SchoolHannoverGermany
| | - Johann Bauersachs
- Department of Cardiology and AngiologyHannover Medical SchoolHannoverGermany
| | - Heiner Wedemeyer
- Department of Gastroenterology, Hepatology, Infectious Diseases and EndocrinologyHannover Medical SchoolHannoverGermany
| | - Frank Wacker
- Department of Diagnostic and Interventional RadiologyHannover Medical SchoolHannoverGermany
| | - Dominik Bettinger
- Department of Medicine IIMedical Center University of FreiburgFreiburg im BreisgauGermany
| | - Jan B. Hinrichs
- Department of Diagnostic and Interventional RadiologyHannover Medical SchoolHannoverGermany
| | - Benjamin Maasoumy
- Department of Gastroenterology, Hepatology, Infectious Diseases and EndocrinologyHannover Medical SchoolHannoverGermany
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Fischer-Rasokat U, Renker M, Charitos EI, Strunk C, Treiber J, Rolf A, Weferling M, Choi YH, Hamm CW, Kim WK. Cardiac decompensation of patients before transcatheter aortic valve implantation-clinical presentation, responsiveness to associated medication, and prognosis. Front Cardiovasc Med 2023; 10:1232054. [PMID: 37942071 PMCID: PMC10627789 DOI: 10.3389/fcvm.2023.1232054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/10/2023] [Indexed: 11/10/2023] Open
Abstract
Aims Cardiac decompensation (CD) in patients with aortic stenosis is a "red flag" for future adverse events. We classified patients undergoing transcatheter aortic valve implantation (TAVI) into those with acute, prior, or no prior CD at the timepoint of TAVI and compared their clinical presentation, prognosis, and effects of the prescribed medication during follow-up. Methods Retrospective analysis of patients of one center fulfilling the criteria of 30-day device success after transfemoral TAVI. Results From those patients with no CD (n = 1,985) ranging to those with prior CD (n = 497) and to those with acute CD (n = 87), we observed a stepwise increase in the proportion of patients in poor clinical condition, NYHA class III/IV, low psoas muscle area, fluid overload (rales, oedema, pleural effusion), reduced ejection fraction, renal insufficiency, and anemia. More diuretics but less renin-angiotensin system inhibitors (ACEI/ARB) were prescribed for patients with acute CD compared to other groups. Prior CD (hazard ratio and 95% CI 1.40; 1.02-1.91) and acute CD (1.72; 1.01-2.91), a reduced general condition (1.53; 1.06-2.20), fluid overload (1.54;1.14-2.08), atrial fibrillation (1.76; 1.32-2.33), and anemia (1.43;1.08-1.89) emerged as strong independent predictors of one-year mortality. In all three classes of CD, prescribing of ACEI/ARB was associated with a substantial improvement of survival. Conclusions The clinical presentation of (acute or prior) cardiac decompensation in patients with AS overlapped substantially with that of patients with classical signs of heart failure. Our results may support an early treatment strategy in patients with left ventricular dysfuntion before clinical signs of congestion are manifest. Moreover, these patients require intensive medical attention after TAVI.
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Affiliation(s)
| | - Matthias Renker
- Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany
- Department of Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhein-Main, Bad Nauheim, Germany
| | | | | | - Julia Treiber
- Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany
| | - Andreas Rolf
- Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhein-Main, Bad Nauheim, Germany
| | - Maren Weferling
- Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhein-Main, Bad Nauheim, Germany
| | - Yeong-Hoon Choi
- Department of Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany
| | - Christian W. Hamm
- Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhein-Main, Bad Nauheim, Germany
- Medical Clinic I (Cardiology and Angiology), University Hospital of Giessen, Giessen, Germany
| | - Won-Keun Kim
- Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany
- Department of Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhein-Main, Bad Nauheim, Germany
- Medical Clinic I (Cardiology and Angiology), University Hospital of Giessen, Giessen, Germany
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Kimball JP, Inan OT, Convertino VA, Cardin S, Sawka MN. Wearable Sensors and Machine Learning for Hypovolemia Problems in Occupational, Military and Sports Medicine: Physiological Basis, Hardware and Algorithms. Sensors (Basel) 2022; 22:442. [PMID: 35062401 DOI: 10.3390/s22020442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/14/2021] [Accepted: 12/30/2021] [Indexed: 11/16/2022]
Abstract
Hypovolemia is a physiological state of reduced blood volume that can exist as either (1) absolute hypovolemia because of a lower circulating blood (plasma) volume for a given vascular space (dehydration, hemorrhage) or (2) relative hypovolemia resulting from an expanded vascular space (vasodilation) for a given circulating blood volume (e.g., heat stress, hypoxia, sepsis). This paper examines the physiology of hypovolemia and its association with health and performance problems common to occupational, military and sports medicine. We discuss the maturation of individual-specific compensatory reserve or decompensation measures for future wearable sensor systems to effectively manage these hypovolemia problems. The paper then presents areas of future work to allow such technologies to translate from lab settings to use as decision aids for managing hypovolemia. We envision a future that incorporates elements of the compensatory reserve measure with advances in sensing technology and multiple modalities of cardiovascular sensing, additional contextual measures, and advanced noise reduction algorithms into a fully wearable system, creating a robust and physiologically sound approach to manage physical work, fatigue, safety and health issues associated with hypovolemia for workers, warfighters and athletes in austere conditions.
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Thom K, Kahl B, Wagner T, van Egmond-Fröhlich A, Krainz M, Frischer T, Leeb I, Schuster C, Ehringer-Schetitska D, Minkov M, Male C, Michel-Behnke I. SARS-CoV-2 Associated Pediatric Inflammatory Multisystem Syndrome With a High Prevalence of Myocarditis - A Multicenter Evaluation of Clinical and Laboratory Characteristics, Treatment and Outcome. Front Pediatr 2022; 10:896252. [PMID: 35757128 PMCID: PMC9227661 DOI: 10.3389/fped.2022.896252] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/06/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Pediatric inflammatory multisystem syndrome - temporally associated with SARS-CoV-2 infection (PIMS -TS) comprises a new disease entity having emerged after the COVID-19 outbreak in 2019. MATERIALS AND METHODS For this multicenter, retrospective study children between 0 and 18 years with PIMS-TS between March 2020 and May 2021 were included, before availability of vaccination for children. Frequent SARS-CoV-2 variants at that period were the wildtype virus, alpha, beta and delta variants. Inclusion criteria were according to the PIMS-TS criteria, proposed by the Royal College of Pediatrics and WHO. Study aim was to review their clinical, laboratory and echocardiographic data with a focus on cardiac involvement. RESULTS We report 45 patients, median age 9 years, 64% male. SARS-CoV-2 antibodies were positive in 35/41 (85%). PIMS occurrence followed local COVID-19 peak incidence periods with a time lag. The most common symptoms at presentation were fever (98%), abdominal pain (89%) and rash (80%). Fever history of > 5 days was associated with decreased left ventricular function (p = 0.056). Arterial hypotension and cardiac dysfunction were documented in 72% patients, increased brain natriuretic peptide in 96% and increased cardiac troponin in 64% of the children. Echocardiography revealed mitral valve regurgitation (64%), coronary abnormalities (36%) and pericardial effusions (40%). Increased NT-proBNP was significantly associated with the need of inotropics (p < 0.05), which were necessary in 40% of the patients. Treatment comprised intravenous immunoglobulin (93%), systemic steroids (84%) and acetylsalicylic acid (100%; 26/45 started with high dosages). For insufficient response to this treatment, five (11%) children received the interleukin-1 receptor antagonist anakinra. All patients were discharged with almost resolved cardiac signs. CONCLUSION Our analysis of non-vaccinated children with PIMS-TS demonstrates that a considerable number have associated myocarditis requiring intensive care and inotropic support. Most children showed adequate response to intravenous immunoglobulin and steroids and good recovery. Further evaluation of pediatric patients with COVID-19 associated diseases is required to evaluate the impact of new virus variants.
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Affiliation(s)
- Katharina Thom
- Department of Pediatrics, Division of Pediatric Cardiology, Pediatric Heart Centre, Medical University of Vienna, Vienna, Austria
| | - Beatrice Kahl
- Department of Pediatrics, Division of Pediatric Cardiology, Pediatric Heart Centre, Medical University of Vienna, Vienna, Austria
| | - Thomas Wagner
- Department of Pediatrics and Adolescent Medicine, Clinic Donaustadt, Vienna, Austria
| | | | - Mathias Krainz
- St. Anna Children's Hospital, Center for Children and Adolescent Medicine, Medical University Vienna, Vienna, Austria
| | - Thomas Frischer
- Department of Pediatrics and Adolescent Medicine, Clinic Ottakring, Sigmund Freud Private University, Vienna, Austria
| | - Iris Leeb
- Department of Pediatrics and Adolescent Medicine, State Hospital Mödling, Mödling, Austria
| | - Christine Schuster
- Department of Pediatrics and Adolescent Medicine, State Hospital Mistelbach-Gänserndorf, Mistelbach, Austria
| | - Doris Ehringer-Schetitska
- Department of Pediatrics and Adolescent Medicine, State Hospital Wiener Neustadt, Wiener Neustadt, Austria
| | - Milen Minkov
- Department of Pediatrics and Adolescent Medicine, Clinic Floridsdorf, Vienna, Austria
| | - Christoph Male
- Department of Pediatrics, Division of Pediatric Cardiology, Pediatric Heart Centre, Medical University of Vienna, Vienna, Austria
| | - Ina Michel-Behnke
- Department of Pediatrics, Division of Pediatric Cardiology, Pediatric Heart Centre, Medical University of Vienna, Vienna, Austria
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Tkaczyszyn M, Skrzypczak T, Michałowicz J, Ponikowski P, Jankowska EA. Iron deficiency as emerging therapeutic target in patients stabilized after an episode of acute heart failure. Cardiol J 2021; 28:962-969. [PMID: 34897633 PMCID: PMC8747834 DOI: 10.5603/cj.a2021.0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 11/28/2021] [Accepted: 11/28/2021] [Indexed: 12/03/2022] Open
Abstract
Acute heart failure (AHF) syndromes are among the most frequent causes of hospitalization in the elderly and put a heavy financial burden on healthcare systems, mainly due to high early readmission rates. The understanding of AHF has evolved over the years from a significant hemodynamic failure to a multi-organ disease in the course of which peripheral mechanisms such as dysregulated cardiorenal axis or inflammation also play essential roles. A few available observational studies investigating iron deficiency (ID) in patients hospitalized for AHF indicate that this comorbidity is more prevalent than in chronic heart failure, and iron status presents some dynamics in these subjects. ID in AHF predicts increased mortality, greater risk for early readmission and is related to prolonged hospitalization. This paper reviews the results of the first multicenter, double-blind, randomized clinical trial on ferric carboxymaltose in patients who were stabilized after an episode of AHF who had concomitant ID (AFFIRM-AHF), and potential pathophysiological links between dysregulated iron status and AHF syndromes are discussed.
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Affiliation(s)
- Michał Tkaczyszyn
- Institute of Heart Diseases, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Tomasz Skrzypczak
- Institute of Heart Diseases, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Jakub Michałowicz
- Institute of Heart Diseases, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Piotr Ponikowski
- Institute of Heart Diseases, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Ewa A Jankowska
- Institute of Heart Diseases, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland.
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Phoophiboon V, Pachinburavan M, Ruamsap N, Sanguanwong N, Jaimchariyatam N. Critical care management of pulmonary arterial hypertension in pregnancy: the pre-, peri- and post-partum stages. Acute Crit Care 2021; 36:286-293. [PMID: 34762794 PMCID: PMC8907465 DOI: 10.4266/acc.2021.00458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 08/31/2021] [Indexed: 11/30/2022] Open
Abstract
The mortality rate of pulmonary hypertension in pregnancy is 25%–56%. Pulmonary arterial hypertension is the highest incidence among this group, especially in young women. Despite clear recommendation of pregnancy avoidance, certain groups of patients are initially diagnosed during the gestational age step into the third trimester. While the presence of right ventricular failure in early gestation is usually trivial, it can be more severe in the late trimester. Current evidence shows no consensus in the management and serious precautions for each stage of the pre-, peri- and post-partum periods of this specific group. Pulmonary hypertension-targeted drugs, mode of delivery, type of anesthesia, and some avoidances should be planned among a multidisciplinary team to enhance maternal and fetal survival opportunities. Sudden circulatory collapse from cardiac decompensation during the peri- and post-partum phases is detrimental, and mechanical support such as extracorporeal membrane oxygenation should be considered for mitigating hemodynamics and extending cardiac recovery time. Our review aims to explain the pathophysiology of pulmonary arterial hypertension and summarize the current evidence for critical management and precautions in each stage of pregnancy.
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Affiliation(s)
- Vorakamol Phoophiboon
- Division of Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Excellence Center for Critical Care Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Monvasi Pachinburavan
- Division of Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Excellence Center for Critical Care Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Nicha Ruamsap
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Natthawan Sanguanwong
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Excellence Center for Sleep Disorder, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Nattapong Jaimchariyatam
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Excellence Center for Sleep Disorder, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
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Schaefer AK, Poschner T, Andreas M, Kocher A, Laufer G, Wiedemann D, Mach M. Impact of Subclinical Congestion on Outcome of Patients Undergoing Mitral Valve Surgery. Biomedicines 2020; 8:E363. [PMID: 32961736 DOI: 10.3390/biomedicines8090363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/04/2020] [Accepted: 09/16/2020] [Indexed: 01/31/2023] Open
Abstract
Since risk assessment prior to cardiac surgery is based on proven but partly unsatisfactory scores, the need for novel tools in preoperative risk assessment taking into account cardiac decompensation is obvious. Even subclinical chronic heart failure is accompanied by an increase in plasma volume. This increase is illustrated by means of a plasma volume score (PVS), calculated using weight, gender and hematocrit. A retrospective analysis of 187 consecutive patients with impaired left ventricular function undergoing mitral valve surgery at a single centre between 2013 and 2016 was conducted. Relative preoperative PVS was generated by subtracting the ideal from actual calculated plasma volume. The study population was divided into two cohorts using a relative PVS score > 3.1 as cut-off. Patients with PVS > 3.1 had a significantly higher need for reoperation for bleeding/tamponade (5.5% vs. 16.7%; p = 0.016) and other non-cardiac causes (9.4% vs. 21.7%; p = 0.022). In-hospital as well as 6-month, 1-year and 5-year mortality was significantly increased in PVS > 3.1 (6.3% vs. 18.3%; p = 0.013; 9.4% vs. 23.3%; p = 0.011; 11.5% vs. 23.3%; p = 0.026; 18.1% vs. 33.3%; p = 0.018). Elevated PVS above the defined cut-off used to quantify subclinical congestion was linked to significantly worse outcome after mitral valve surgery and therefore could be a useful addition to current preoperative risk stratification.
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Adlbrecht C, Piringer F, Resar J, Watzal V, Andreas M, Strouhal A, Hasan W, Geisler D, Weiss G, Grabenwöger M, Delle‐Karth G, Mach M. The impact of subclinical congestion on the outcome of patients undergoing transcatheter aortic valve implantation. Eur J Clin Invest 2020; 50:e13251. [PMID: 32323303 PMCID: PMC7507141 DOI: 10.1111/eci.13251] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/02/2020] [Accepted: 04/13/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND We investigated the impact of an elevated plasma volume status (PVS) in patients undergoing TAVI on early clinical safety and mortality and assessed the prognostic utility of PVS for outcome prediction. MATERIALS AND METHODS We retrospectively calculated the PVS in 652 patients undergoing TAVI between 2009 and 2018 at two centres. They were then categorized into two groups depending on their preoperative PVS (PVS ≤-4; n = 257 vs PVS>-4; n = 379). Relative PVS was derived by subtracting calculated ideal (iPVS = c × weight) from actual plasma volume (aPVS = (1 - haematocrit) × (a + (b × weight in kg)). RESULTS The need for renal replacement therapy (1 (0.4%) vs 17 (4.5%); P = .001), re-operation for noncardiac reasons (9 (3.5%) vs 32 (8.4%); P = .003), re-operation for bleeding (9 (3.5%) vs 27 (7.1%); P = .037) and major bleeding (14 (5.4%) vs 37 (9.8%); P = .033) were significantly higher in patients with a PVS>-4. The composite 30-day early safety endpoint (234 (91.1%) vs 314 (82.8%); P = .002) confirms that an increased preoperative PVS is associated with a worse overall outcome after TAVI. CONCLUSIONS An elevated PVS (>-4) as a marker for congestion is associated with significantly worse outcome after TAVI and therefore should be incorporated in preprocedural risk stratification.
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Affiliation(s)
- Christopher Adlbrecht
- Vienna North Hospital – Clinic Floridsdorf and the Karl Landsteiner Institute for Cardiovascular and Critical Care Research ViennaViennaAustria
| | - Felix Piringer
- Vienna North Hospital – Clinic Floridsdorf and the Karl Landsteiner Institute for Cardiovascular and Critical Care Research ViennaViennaAustria
| | - Jon Resar
- Division of CardiologyDepartment of MedicineJohns Hopkins University School of MedicineBaltimoreMDUSA
| | - Victoria Watzal
- Department of Cardio‐Vascular SurgeryHospital Hietzing and Karl Landsteiner Institute for Cardio‐Vascular ResearchViennaAustria
| | - Martin Andreas
- General Hospital Vienna, Division of Cardiac SurgeryMedical University of ViennaViennaAustria
| | - Andreas Strouhal
- Vienna North Hospital – Clinic Floridsdorf and the Karl Landsteiner Institute for Cardiovascular and Critical Care Research ViennaViennaAustria
| | - Waseem Hasan
- Faculty of MedicineImperial College LondonLondonUK
| | - Daniela Geisler
- Department of Cardio‐Vascular SurgeryHospital Hietzing and Karl Landsteiner Institute for Cardio‐Vascular ResearchViennaAustria
| | - Gabriel Weiss
- Department of Cardio‐Vascular SurgeryHospital Hietzing and Karl Landsteiner Institute for Cardio‐Vascular ResearchViennaAustria
| | - Martin Grabenwöger
- Department of Cardio‐Vascular SurgeryHospital Hietzing and Karl Landsteiner Institute for Cardio‐Vascular ResearchViennaAustria
- Faculty of MedicineSigmund Freud UniversityViennaAustria
| | - Georg Delle‐Karth
- Vienna North Hospital – Clinic Floridsdorf and the Karl Landsteiner Institute for Cardiovascular and Critical Care Research ViennaViennaAustria
| | - Markus Mach
- Department of Cardio‐Vascular SurgeryHospital Hietzing and Karl Landsteiner Institute for Cardio‐Vascular ResearchViennaAustria
- Faculty of MedicineSigmund Freud UniversityViennaAustria
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9
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Klug D. [Pressure sensors to prevent cardiac decompensation]. Soins 2017; 62:50-52. [PMID: 29153221 DOI: 10.1016/j.soin.2017.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Most cases of hospitalisation for heart failure are preceded by episodes of cardiac decompensation. Preventing these episodes would improve quality of life and reduce mortality and treatment costs. The monitoring of intracardiac pressures, using innovative sensors, coupled with telemedicine, offers interesting perspectives.
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Affiliation(s)
- Didier Klug
- Service de rythmologie, CHRU de Lille, 2, avenue Oscar-Lambret, 59000 Lille, France.
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10
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Sato Y, Taniguchi R, Makiyama T, Nagai K, Okada H, Yamada T, Matsumori A, Takatsu Y. Serum cardiac troponin T and plasma brain natriuretic peptide in patients with cardiac decompensation. Heart 2002; 88:647-8. [PMID: 12433908 PMCID: PMC1767451 DOI: 10.1136/heart.88.6.647] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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