The Association of the Pulmonary Artery Pulsatility Index and Right Ventricular Function after Cardiac Surgery

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-02-13 DOI:10.1155/2024/5408008

Johnny Wei, Abigail Kee, Rachel Dukes, Jack Franke, Vincent Leonardo, B. Flynn

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Abstract

Background. The pulmonary artery pulsatility index (PAPi) has been shown to correlate with right ventricular (RV) failure in patients with cardiac disease. However, the association of PAPi with right ventricular function following cardiac surgery is not yet established. Methods. PAPi and other hemodynamic variables were obtained postoperatively for 959 adult patients undergoing cardiac surgery. The association of post-bypass right ventricular function and other clinical factors to PAPi was evaluated using linear regression. A propensity-score matched cohort for PAPi ≥ 2.00 was used to assess the association of PAPi with postoperative outcomes. Results. 156 patients (16.3%) had post-bypass right ventricular dysfunction defined by visualization on transesophageal echocardiography. There was no difference in postoperative PAPi based on right ventricular function (2.12 vs. 2.00, p=0.21). In our matched cohort (n = 636), PAPi < 2.00 was associated with increased incidence of acute kidney injury (23.0% vs 13.2%, p<0.01) and ventilator time (6.0 hours vs 5.6 hours, p=0.04) but not with 30-day mortality or intensive care unit length of stay. Conclusion. In a general cohort of patients undergoing cardiac surgery, postoperative PAPi was not associated with postcardiopulmonary bypass right ventricular dysfunction. A postoperative PAPi < 2 may be associated with acute kidney injury.

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心脏手术后肺动脉搏动指数与右心室功能的关系

背景。肺动脉搏动指数（PAPi）已被证明与心脏病患者的右心室（RV）功能衰竭相关。然而，肺动脉搏动指数与心脏手术后右心室功能的关系尚未确定。方法。对 959 名接受心脏手术的成年患者术后的 PAPi 和其他血液动力学变量进行了采集。采用线性回归方法评估了心脏搭桥术后右心室功能和其他临床因素与 PAPi 的关系。使用 PAPi ≥ 2.00 的倾向分数匹配队列来评估 PAPi 与术后结果的关系。结果。156名患者（16.3%）在经食道超声心动图检查中发现搭桥术后右心室功能障碍。基于右心室功能的术后 PAPi 没有差异（2.12 vs. 2.00，P=0.21）。在我们的匹配队列（n = 636）中，PAPi < 2.00 与急性肾损伤发生率（23.0% vs 13.2%，p<0.01）和呼吸机时间（6.0 小时 vs 5.6 小时，p=0.04）增加有关，但与 30 天死亡率或重症监护室住院时间无关。结论在接受心脏手术的普通患者群体中，术后 PAPi 与心肺旁路术后右心室功能障碍无关。术后 PAPi < 2 可能与急性肾损伤有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.