Key result
Preoperative LVESVI >100 mL/m2 is linked to death and a ~62% postoperative CHF rate.
Why the study?
Does preoperative LVESVI predict death and postoperative congestive heart failure in patients with ischemic cardiomyopathy and EF < 0.30?
Cohort (n=41)
Does preoperative LVESVI predict death and postoperative congestive heart failure in patients with ischemic cardiomyopathy and EF < 0.30?
Preoperative LVESVI > 100 mL/m2 is a strong independent predictor of mortality and postoperative congestive heart failure in patients with ischemic cardiomyopathy and severe left ventricular dysfunction.
May inform preoperative risk stratification in low-EF ischemic cardiomyopathy; hypothesis-generating and should not yet change surgical thresholds.
BACKGROUND: The left ventricular end-systolic volume index (LVESVI) helps to predict postoperative left ventricular function in patients with ischemic cardiomyopathy. METHODS: We retrospectively assessed the ability of preoperative variables to predict death and the development of postoperative congestive heart failure in 41 patients with a preoperative ejection fraction of less than 0.30. RESULTS: A preoperative LVESVI of greater than 100 mL/m2 was identified as an independent predictor of death by Cox's proportional hazards model. Diabetes and a preoperative LVESVI of greater than 100 mL/m2 were independent predictive risk factors for the development of postoperative congestive heart failure. Postoperative congestive heart failure developed in 2 of the 23 patients (8.7%) who had a preoperative LVESVI of less than 100 mL/m2 and in 10 of the 16 patients (62.5%) who had a preoperative LVESVI of greater than 100 mL/m2. The actuarial survival rate during follow-up in patients who had a preoperative LVESVI of less than 100 mL/m2 was significantly greater than that in patients who had a preoperative LVESVI of greater than 100 mL/m2. The actuarial rate of freedom from congestive heart failure during the follow-up period also was greater in patients who had a preoperative LVESVI of less than 100 mL/m2. CONCLUSIONS: Our results suggest that the preoperative LVESVI predicts the development of postoperative congestive heart failure and the actuarial survival rate in patients with ischemic cardiomyopathy.
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Yamaguchi et al. (1998) conducted a cohort in Ischemic cardiomyopathy (n=41). Preoperative LVESVI > 100 mL/m2 vs. Preoperative LVESVI < 100 mL/m2 was evaluated on Development of postoperative congestive heart failure. A preoperative LVESVI >100 mL/m2 was an independent predictor of death and associated with a higher rate of postoperative congestive heart failure compared to LVESVI <100 mL/m2 (62.5% vs 8.7%).
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