Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery

The value of systolic pressure in the pulmonary artery as a risk factor for organ dysfunction in patients operated on heart valves

Authors: Yudin G.V., Goncharov A.A., Rybka M.M., Mironenko V.A., Rychin S.V.

Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, 121552, Russian Federation

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UDC: 616.12-007.42

Link: Clinical Physiology of Blood Circulaiton. 2020; 17 (2): 107-115

Quote as: Yudin G.V., Goncharov A.A., Rybka M.M., Mironenko V.A., Rychin S.V. The value of systolic pressure in the pulmonary artery as a risk factor for organ dysfunction in patients operated on heart valves. Clinical Physiology of Circulation. 2020; 17 (2): 107–15 (in Russ.). DOI: 10.24022/1814-6910-2020-17-2-107-115

Received / Accepted:  16.12.2019/26.12.2019

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Objective. To determine the effect of increased pulmonary artery pressure on the risk of organ dysfunction in patients operated on heart valves.

Material and methods. The study is single-center, retrospective, randomized. A comparative analysis of the frequency and structure of organ dysfunction in the early postoperative period in 3945 patients with heart valves diseases, divided into 3 groups depending on the presence of high pulmonary artery pressure (PAP) and its value, according to the criteria of the risk scale of cardiac surgery EuroSCORE II: the group of normal PAP (systolic PAP (PAPsyst) not more than 31 mm Hg) – 2655 patients, the group of moderate PAP (PAPsyst 31–55 mm Hg) – 849 patients and the group of high PAP (PAPsyst over 55 mm Hg) – 441 patients.

Results. Increased PAP was a risk factor for early postoperative acute heart failure (odds ratio (OR) 1.9; 95% confidence interval (CI) 1.61–2.19, p<0.05), decreased contractility of the left ventricular myocardium (left ventricular ejection fraction less than 50%) (OR 2.0; 95% CI 1.79–2.29, p<0.05), impaired oxygenating lung function (OR 1.2; 95% CI 1.06–1.34, p<0.05), including acute respiratory distress syndrome (ARDS) (OR 4.0; 95% CI 3.39–4.61, p<0.05) and multiple organ failure (OR 1.8; 95% CI 1.47–2.13, p<0.05). The risk factor for hepatic dysfunction was only high PAP (OR 1.4; 95% CI 1.09–1.71, p<0.05). The presence of elevated PAP doubled postoperative mortality (OR 2.1; 95% CI 1.67–2.53, p<0.05).

Conclusion. Increased PAP is a risk factor for acute heart failure, impaired oxygenating lung function, ARDS, multiple organ failure in the early postoperative period and increased postoperative mortality in patients with heart valves diseases.


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About Authors

  • Gennadiy V. Yudin, Cand. Med. Sc., Anesthesiologist-Intensivist; 0000-0001-9976-6206
  • Andrey A. Goncharov, Anesthesiologist-Intensivist; 0000-0003-2122-7813
  • Mikhail M. Rybka, Dr. Med. Sc., Head of Department of Anesthesiology; 0000-0001-8206-8794
  • Vladimir A. Mironenko, Dr. Med. Sc., Head of Department of Reconstructive Surgery and the Aortic Root; 0000-0003-1533-6212
  • Sergey V. Rychin, Dr. Med. Sc., Leading Researcher; 0000-0002-5796-6872

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