Perioperative evolution of chronic heart failure phenotype in patients with cardiac surgery.

Authors

  • CAZAKU Janna IMSP Institutul de Cardiologie, Laboratorul de Insuficiență Cardiacă Cronică
  • BURSACOVSCHI Daniela IMSP Institutul de Cardiologie, Laboratorul de Insuficiență Cardiacă Cronică
  • DOGOT Marta IMSP Institutul de Cardiologie, Laboratorul de Insuficiență Cardiacă Cronică
  • LISII Dorin IMSP Institutul de Cardiologie, Laboratorul de Insuficiență Cardiacă Cronică
  • TOFAN Victoria IMSP Institutul de Cardiologie, Laboratorul de Insuficiență Cardiacă Cronică
  • URECHE Andrei IMSP Institutul de Cardiologie, Laboratorul de Insuficiență Cardiacă Cronică
  • MOSCALU Vitalie V. IMSP Institutul de Cardiologie, Laboratorul de Insuficiență Cardiacă Cronică
  • BATRINAC Aureliu IMSP Institutul de Cardiologie, Laboratorul de Insuficiență Cardiacă Cronică
  • MOSCALU Vitalie D. IMSP Institutul de Cardiologie, Laboratorul de Insuficiență Cardiacă Cronică
  • VATAMAN Eleonora IMSP Institutul de Cardiologie, Laboratorul de Insuficiență Cardiacă Cronică

DOI:

https://doi.org/10.52692/1857-0011.2022.1-72.08

Keywords:

heart failure, coronary artery by-pass grafting, valvular correction

Abstract

Background. Heart failure (HF) is a well-defined risk factor for early mortality and morbidity after cardiac surgery.We aimed to analyze the evolution of the clinical phenotype of HF at an early stage after heart surgery.Methods. The study included 126 consecutive patients with established chronic HF who fulfilled the cardiac rehabilitation program after undergoing heart surgery (62.23±8.59 years, 67.5% - men). Subjects were divided into 3 groups according to the clinical phenotype of HF: group 1 - HF with reduced left ventricular (LV) ejection fraction (EF) (HFrEF), group 2 - HF with mildly reduced LV EF (HFmrEF) and group 3 - HF with preserved LV EF (HFpEF). All patients were investigated by electrocardiography, transthoracic echocardiography, 6 minutes walk test and assessment of serum NT-proBNP level. Results. Preoperatively, 23.9% of patients had HFrEF, 24.8% - HFmrEF and 51.3% - HFpEF. Analyzing the evolution of the HF phenotype in the early postoperative period, we found that most patients remained in the same group. However, among patients with preoperative HFmrEF, in 22.2% of patients there was an increase in LV EF over 50% and in 22.2% of patients was determined a reduced LV EF, p<0.001. The most obvious positive dynamic of the HF phenotype was attested in patients with HFrEF, where 37% of them presented a mildly reduced LV EF postoperatively, p <0.001. 78.9% of individuals with HFpEF remained in the same group, but 21% showed a decrease in LV EF, p<0.001. Conclusions. At the early stage after cardiac surgery, the most positive evolution of HF phenotype was noticed in the group of patients with HFrEF. Of the 44.4% of patients with HFmrEF who switched to another HF phenotype, only a half reported an increase in LV EF over 50%. The vast majority of patients with HFpEF had the same HF phenotype postoperatively.

Author Biographies

CAZAKU Janna, IMSP Institutul de Cardiologie, Laboratorul de Insuficiență Cardiacă Cronică

studentă-doctorandă, cercet. șt.,

BURSACOVSCHI Daniela, IMSP Institutul de Cardiologie, Laboratorul de Insuficiență Cardiacă Cronică

studentă-doctorandă, cercet. șt.,

DOGOT Marta, IMSP Institutul de Cardiologie, Laboratorul de Insuficiență Cardiacă Cronică

studentă-doctorandă, cercet. șt.,

LISII Dorin, IMSP Institutul de Cardiologie, Laboratorul de Insuficiență Cardiacă Cronică

conf., cercet., dr. șt. med

TOFAN Victoria, IMSP Institutul de Cardiologie, Laboratorul de Insuficiență Cardiacă Cronică

cercet. șt.,

URECHE Andrei, IMSP Institutul de Cardiologie, Laboratorul de Insuficiență Cardiacă Cronică

medic cardiochirurg

MOSCALU Vitalie V., IMSP Institutul de Cardiologie, Laboratorul de Insuficiență Cardiacă Cronică

medic cardiochirurg

BATRINAC Aureliu, IMSP Institutul de Cardiologie, Laboratorul de Insuficiență Cardiacă Cronică

conf., cercet., dr. șt. med,

MOSCALU Vitalie D., IMSP Institutul de Cardiologie, Laboratorul de Insuficiență Cardiacă Cronică

conf., cercet., dr. șt. med,

VATAMAN Eleonora, IMSP Institutul de Cardiologie, Laboratorul de Insuficiență Cardiacă Cronică

prof. univ., dr. hab. șt. med.

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Published

2022-04-08