Differences in Biomarkers Pattern Between Severe Isolated Right and Left Ventricular Dysfunction After Cardiac Surgery

Kim, Jun‐Hyun; Lerose, Caterina Cecilia; Landoni, Giovanni; Prima, Ambra Licia Di; Licheri, Margherita; Oriani, A.; Alaidroos, Moad; Zangrillo, Alberto; Monaco, Fabrizio

doi:10.1053/j.jvca.2019.07.128

Cited by 6 publications

(4 citation statements)

References 20 publications

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“…A recent study showed that patients with severe isolated right ventricular dysfunction had higher total bilirubin than those with severe isolated LV dysfunction after cardiac surgery. 44 Bilirubin level is mainly affected by chronic congestion due to heart failure and right ventricular dysfunction. 44,45 We believe that new onset LVSD and LVDD in severe sepsis and septic shock patients lead to early liver hyperemia, and liver metabolism is enhanced, leading to decreased bilirubin levels.…”

Section: Discussionmentioning

confidence: 99%

“…44 Bilirubin level is mainly affected by chronic congestion due to heart failure and right ventricular dysfunction. 44,45 We believe that new onset LVSD and LVDD in severe sepsis and septic shock patients lead to early liver hyperemia, and liver metabolism is enhanced, leading to decreased bilirubin levels. Bilirubin is increased in cases of liver congestion.…”

Section: Discussionmentioning

confidence: 99%

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Association between left ventricular diastolic dysfunction and septic acute kidney injury in severe sepsis and septic shock: A multicenter retrospective study

Cheng

Liu

et al. 2021

Perfusion

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Introduction: Left ventricular diastolic dysfunction (LVDD) adversely impacts renal function, and E/e′ is a significant predictor of adverse kidney events under different clinical conditions. However, no studies have evaluated the association between LVDD and septic acute kidney injury (AKI) among patients with severe sepsis and septic shock. Methods: This multicenter retrospective study evaluated adult patients with severe sepsis or septic shock between January 1, 2013, and December 31, 2019, who underwent echocardiography within 24 hours after admission to an intensive care unit. Results: A total of 495 adult patients were enrolled in the study. LVDD grades II and III were associated with severe (stage 3) AKI ( p < 0.001, p for trend < 0.001). E/e′ and e′ were risk factors for septic AKI (OR, 1.155; 95% CI, 1.088–1.226, p < 0.001; and OR, 7.218; 95% CI, 2.942–17.712, p < 0.001, respectively) in the multivariate logistic regression analysis. The area under the receiver operating characteristic curve of E/e′ and e′ was 0.728 (95% CI, 0.680–0.777, p < 0.001) and 0.715 (95% CI, 0.665–0.764, p < 0.001), respectively. Conclusions: LVDD was associated with septic AKI, and E/e′ and e′ are useful predictors of septic AKI among patients with severe sepsis or septic shock. Trial registration The study was registered at the Chinese Clinical Trial Registry (Protocol No. ChiCTR2000033083).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Association between left ventricular diastolic dysfunction and septic acute kidney injury in severe sepsis and septic shock: A multicenter retrospective study

Cheng

Liu

et al. 2021

Perfusion

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“…Ameliyat sırası dönemde yetersiz miyokardiyal koruma, sağ koroner arterdeki hava embolisi veya cerrahi sonrası venöz greftin king olması da sağ ventrikül kontraktilitesini etkiler. [32] Akut RV yetmezliğinin, kalp cerrahisi hastalarının %0.04 ila %0.1'inde meydana geldiği bildirilmiştir. [2] Kardiyopulmoner baypas sonrası ciddi bir RV yetmezliği, %86'ya varan yüksek mortalite oranları ile ilişkilidir.…”

Section: Ventriküler Yetmezlikunclassified

Cardiopulmonary bypass weaning process, encountered challenges, and the management

Bilgili¹

2022

Cardiovasc Perf Nurs

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Weaning from cardiopulmonary bypass (CPB) requires the heart to resume its function as the driving force of blood flow, taking over from the mechanical pump in the CPB circuit. Weaning, the process of transition from CPB to physiological circulation, requires excellent communication and teamwork between the perfusionist, surgeon, and anesthetist. Cardiac function must be optimized prior to weaning from CPB to achieve a smooth transition. Delays in investigating or treating abnormal parameters may lead to the heart failing, necessitating a return to extracorporeal circulation. Consequently, anticipation of possible cardiac dysfunction and thorough advance preparation are key elements of the weaning process. This article aimed to mention the weaning process, difficulties, and management of CPB.

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“…Moderate to advanced heart failure can produce liver disease secondary to liver congestion (i.e., cardiac or congestive hepatopathy) ( 60 ). Advanced congestion, low cardiac output that causes hypoperfusion, and right-heart failure caused by severe tricuspid regurgitation or pulmonary hypertension (i.e., pulmonary artery systolic pressure >45 mmHg) are among its causes ( 82 ). Cardiac hepatopathy is usually partially or completely reversed when cardiac problems are corrected.…”

Section: Pathophysiological Considerations Of Liver Disease In Cardia...mentioning

confidence: 99%

The importance of liver function assessment before cardiac surgery: A narrative review

López-Delgado

Putzu²,

Landoni³

2022

Front. Surg.

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The demand for cardiac surgery procedures is increasing globally. Thanks to an improvement in survival driven by medical advances, patients with liver disease undergo cardiac surgery more often. Liver disease is associated with the development of heart failure, especially in patients with advanced cirrhosis. Cardiovascular risk factors can also contribute to the development of both cardiomyopathy and liver disease and heart failure itself can worsen liver function. Despite the risk that liver disease and cirrhosis represent for the perioperative management of patients who undergo cardiac surgery, liver function is often not included in common risk scores for preoperative evaluation. These patients have worse short and long-term survival when compared with other cardiac surgery populations. Preoperative evaluation of liver function, postoperative management and close postoperative follow-up are crucial for avoiding complications and improving results. In the present narrative review, we discuss the pathophysiological components related with postoperative complications and mortality in patients with liver disease who undergo cardiac surgery and provide recommendations for the perioperative management.

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Differences in Biomarkers Pattern Between Severe Isolated Right and Left Ventricular Dysfunction After Cardiac Surgery

Cited by 6 publications

References 20 publications

Association between left ventricular diastolic dysfunction and septic acute kidney injury in severe sepsis and septic shock: A multicenter retrospective study

Association between left ventricular diastolic dysfunction and septic acute kidney injury in severe sepsis and septic shock: A multicenter retrospective study

Cardiopulmonary bypass weaning process, encountered challenges, and the management

The importance of liver function assessment before cardiac surgery: A narrative review

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