Echocardiographic Probability of Pulmonary Hypertension in Cardiac Surgery Patients—Occurrence and Association with Respiratory Adverse Events—An Observational Prospective Single-Center Study

Abstract

Background: Pulmonary hypertension (PH) is an independent risk factor of increased morbidity and mortality in cardiac surgery patients (CS). The most common cause underlying PH is left ventricular (LV) diastolic dysfunction. This study aimed to evaluate the echocardiographic probability of PH in patients undergoing CS and its correlation with postoperative respiratory adverse events (RAE). Methods: The echocardiographic probability of PH and its correlation with LV diastolic dysfunction was assessed in 56 consecutive adult patients who were qualified for coronary artery bypass grafting (CABG). Later, the postoperative RAE (such as pneumonia, pulmonary congestion, or hypoxemia), the length of intensive care unit (ICU) treatment and mortality in groups with moderate or high (PH-m/h) and low (PH-l) probability of pulmonary hypertension were examined. Results: PH-m/h was observed in 29 patients, of whom 65.5 % had LV diastolic dysfunction stage II or III. A significantly higher occurrence of RAE was observed in the PH-m/h group as compared to the PH-l group. There were no differences between the PH-m/h and PH-l patient groups regarding the in-hospital length of stay or mortality. Conclusions: High or intermediate probability of PH is common in cardiac surgical patients with left ventricular diastolic dysfunction and correlates with respiratory adverse events.

The Impact of Left Ventricular Diastolic Dysfunction on Respiratory Adverse Events in Cardiac Surgery Patients—An Observational Prospective Single-Center Study

“…Increased RVSP and sPAP are characteristic of PH. In the first part of our study, published in 2022, we observed high or moderate echocardiographic probability of PH in 51.7% (n = 29) of our patients, from which 19 presented diastolic dysfunction stage II or III [30]. The impact of diastolic dysfunction on echocardiographic signs of elevated RV pressure and sPAP explains the differences in EuroScore II in our study.…”