Share this page on LinkedIn
Share This Page on Google+
Share This Page on Twitter
tell someone about this page print this page
You are here: Contents > 2012 > Volume 21 Number 6 November 2012 > MISCELLANEOUS > The Impact of Pulmonary Hypertension on Outcomes of Patients with Low Left Ventricular Ejection Fraction: A Propensity Analysis

The Impact of Pulmonary Hypertension on Outcomes of Patients with Low Left Ventricular Ejection Fraction: A Propensity Analysis

Changyong Yang, Dadong Li, Roger Mennett, Jonathan Hammond, Gong Zhang, Donghui Chen, Justin Lundbye, Robert Gallagher
Cardiovascular Surgery Department of Qilu Hospital of Shandong University, Jinan, China, Departments of Research, Cardiology and Cardiothoracic Surgery, Hartford Hospital, Hartford, CT, USA

Background and aim of the study: Pulmonary hypertension (PH) is commonly described as a risk factor in cardiac surgery; however, the effect of a low left ventricular ejection fraction (LVEF) on PH has not been assessed. Hence, the study aim was to determine whether PH increases operative mortality and survival outcome in patients with a low LVEF.
Methods: Between January 2001 and September 2009, a total of 845 consecutive patients with LVEF <40% was enrolled into the study. Among these patients, 444 had a pulmonary pressure <40 mmHg (NPH group), while in 401 patients the pulmonary pressure was ≥40 mmHg.
Results: Preoperatively, the PH patients were older
(p <0.001), had a lower LVEF (p = 0.001), and had a higher logistic EuroSCORE (p <0.001) and serum creatinine level (p <0.026) when compared to NPH patients. The PH patients showed a greater tendency to develop postoperative complications (p <0.001).

After adjusting by propensity score, the in-hospital mortality was significantly higher among PH patients (p <0.001), while multivariate logistic regressions revealed PH as an independent predictor for in-hospital mortality (p = 0.036). The 12-, 36-, and 60-month follow up mortality rates were significantly higher in the PH group. By using a Cox logistic regression model, PH was shown to be an independent predictor for follow up mortality
(p = 0.035).
Conclusion: Pulmonary hypertension increased the morbidity and mortality in patients with a low LVEF who were undergoing cardiac surgery. Future studies may identify subgroups that may benefit from a preoperative optimization of PH and/or intra- and postoperative therapies directed at minimizing the effects of the condition.

The Journal of Heart Valve Disease 2012;21:767-773

The Impact of Pulmonary Hypertension on Outcomes of Patients with Low Left Ventricular Ejection Fraction: A Propensity Analysis

Click the above hyperlink to view the article, right click (Ctrl click on a Mac) to open in a new browser window or tab.

Purchase this Article

Please click the button below to purchase this article. Single article purchases are provided at $50.00 per article. Upon clicking the button below, single article user account subscription details are requested and, upon successful payment, a single article user account is created. Single articles are availble in your account for seven days after purchase.