Clinical and hemodynamic predictors of survival in patients aged &lt;65 years with severe congestive heart failure secondary to ischemic or nonischemic dilated cardiomyopathy

Anguita, Manuel; Arizón, José M.; Bueno, Gregorio Manzanera; Latre, J.M.; Sancho, Manuel; Torres, Francisco; Giménez, D; Concha, Manuel; Vallés, F

doi:10.1016/0002-9149(93)91132-2

Cited by 68 publications

(26 citation statements)

References 18 publications

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“…Other factors, including severely depressed peak oxygen consumption [25], right ventricular failure [26], dependence on intravenous inotropes [27], low serum sodium [28] or high natriuretic peptide concentrations [29], or renal intolerance of ACE inhibitors [30] are used to identify high risk populations. As observed by others [4][5][6], the underlying heart disease had no effect on survival among patients with end stage CHF in our Comparison Group.…”

Section: Discussionsupporting

confidence: 79%

The long-term survival benefit conferred by intermittent dobutamine infusions and oral amiodarone is greater in patients with idiopathic dilated cardiomyopathy than with ischemic heart disease

Tsagalou

Anastasiou-Nana

Terrovitis

et al. 2006

International Journal of Cardiology

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Section: Discussionsupporting

confidence: 79%

The long-term survival benefit conferred by intermittent dobutamine infusions and oral amiodarone is greater in patients with idiopathic dilated cardiomyopathy than with ischemic heart disease

Tsagalou

Anastasiou-Nana

Terrovitis

et al. 2006

International Journal of Cardiology

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“…It is known that the clinical treatment yields poor results with high mortality 10. CABG in these patients is challenging, with reduced ventricular function directly reflecting procedure risk and representing an independent risk factor for morbidity and mortality 11,12.…”

Section: Discussionmentioning

confidence: 99%

Off-pump coronary artery bypass surgery in selected patients is superior to the conventional approach for patients with severely depressed left ventricular function

Caputti

Palma

Gaia

et al. 2011

Clinics

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OBJECTIVES:Patients with coronary artery disease and left ventricular dysfunction have high mortality when kept in clinical treatment. Coronary artery bypass grafting can improve survival and the quality of life. Recently, revascularization without cardiopulmonary bypass has been presented as a viable alternative. The aim of this study is to compare patients with left ventricular ejection fractions of less than 20% who underwent coronary artery bypass graft with or without cardiopulmonary bypass.METHODS:From January 2001 to December 2005, 217 nonrandomized, consecutive, and nonselected patients with an ejection fraction less than or equal to 20% underwent coronary artery bypass graft surgery with (112) or without (off-pump) (105) the use of cardiopulmonary bypass. We studied demographic, operative, and postoperative data.RESULTS:There were no demographic differences between groups. The outcome variables showed similar graft numbers in both groups. Mortality was 12.5% in the cardiopulmonary bypass group and 3.8% in the off-pump group. Postoperative complications were statistically different (cardiopulmonary bypass versus off-pump): total length of hospital stay (days)—11.3 vs. 7.2, length of ICU stay (days)—3.7 vs. 2.1, pulmonary complications—10.7% vs. 2.8%, intubation time (hours)—22 vs. 10, postoperative bleeding (mL)—654 vs. 440, acute renal failure—8.9% vs. 1.9% and left-ventricle ejection fraction before discharge—22% vs. 29%.CONCLUSION:Coronary artery bypass grafting without cardiopulmonary bypass in selected patients with severe left ventricular dysfunction is valid and safe and promotes less mortality and morbidity compared with conventional operations.

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“…2 In addition, prior analyses have implicated nearly every hemodynamic parameter as the most important predictor of death, including mean right atrial pressure, 10 PAS, 1 pulmonary artery diastolic pressure, 11 PCW, 12 and systolic blood pressure. 13 This seem- …”

Section: Discussionmentioning

confidence: 96%

Pulmonary Hypertension and Risk of Death in Cardiomyopathy

et al. 2002

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Background-Pulmonary hypertension is a clinically useful predictor of death in patients with heart failure. Whether pulmonary hypertension has the same prognostic value among specific underlying causes of cardiomyopathy is unknown. Using a diverse cohort of cardiomyopathy patients, we tested the hypotheses that (1) elevated mean pulmonary arterial pressure is the most important hemodynamic predictor of death and (2) the prognostic value of mean pulmonary pressure varies among different cardiomyopathies. Methods and Results-Patients (nϭ1134) with new cardiomyopathy were prospectively assigned a specific diagnosis on the basis of clinical evaluation and endomyocardial biopsy. All patients underwent right heart catheterization at baseline and were followed for an average of 4.4 years. In multivariate Cox models that allowed for nonlinear relations between hemodynamics and death, mean systemic pressure (mSP) and mean pulmonary arterial pressure (mPA) emerged as the most important hemodynamic predictors of death. Moreover, there was a statistically significant positive interaction between mPA and the diagnosis of myocarditis. For each 5-mm Hg increase in baseline mSP, mortality rates decreased with relative hazard (RH) of 0.89 (0.86 to 0.92). For a 5-mm Hg increase in baseline mPA, mortality rates increased in patients who did not carry the diagnosis of myocarditis with RH 1.23 (1.17 to 1.29); among patients with myocarditis, mortality rates increased substantially with RH of 1.85 (1.50 to 2.29; PϽ0.001 for interaction). Conclusions-Baseline mPA is particularly important for stratifying risk in myocarditis. These findings suggest that secondary pulmonary hypertension may have different biological features in myocarditis and that patients with pulmonary hypertension and myocarditis should be targeted for aggressive medical therapy.

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Clinical and hemodynamic predictors of survival in patients aged <65 years with severe congestive heart failure secondary to ischemic or nonischemic dilated cardiomyopathy

Cited by 68 publications

References 18 publications

The long-term survival benefit conferred by intermittent dobutamine infusions and oral amiodarone is greater in patients with idiopathic dilated cardiomyopathy than with ischemic heart disease

The long-term survival benefit conferred by intermittent dobutamine infusions and oral amiodarone is greater in patients with idiopathic dilated cardiomyopathy than with ischemic heart disease

Off-pump coronary artery bypass surgery in selected patients is superior to the conventional approach for patients with severely depressed left ventricular function

Pulmonary Hypertension and Risk of Death in Cardiomyopathy

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