scholarly journals Baseline and Outcome Characteristics of Multiple Valve Surgery Compared with Single Valve Procedures in Mainland China: A Multicenter Experience

2019 ◽  
Vol 22 (6) ◽  
pp. E486-E493
Author(s):  
Lei Jin ◽  
Guan-xin Zhang ◽  
Lin Han ◽  
Chong Wang
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Congestive Heart Failure ◽  
Mainland China ◽  
Valve Surgery ◽  
Chronic Obstructive ◽  
Class Iii ◽  
Obstructive Pulmonary Disease ◽  
Baseline Characteristics

Background: To compare baseline and outcome characteristics of multiple valve surgery with single-valve procedures in a multicenter patient population of mainland China. Methods: From January 2008 to December 2012, data from 14,322 consecutive patients older than 16 years who underwent heart valve surgery at five cardiac surgical centers (except pulmonary valve operations) were collected. The patients were divided into seven subgroups according to the type of valve procedures, and baseline characteristics and postoperative outcomes were contrasted between all seven combinations of single-valve and multiple-valve procedures involving aortic, mitral, and tricuspid valves. Two independent logistic regression analyses were performed and multivariable risk factors for mortality were compared, with emphasis on single-valve versus multiple-valve surgery. Results: Baseline characteristics for MUV procedures (n = 8945) shared many differences to those for single-valve procedures (n = 5377). Proportion of females, chronic obstructive pulmonary disease, cerebrovascular disease, renal impairment, congestive heart failure, NHYA class III-IV, atrial fibrillation, pulmonary hypertension, and decreased ejection fraction were more common in MUV subgroups, and smoker, hypertension, dyslipidemia, active infectious endocarditis, and coronary bypass graft was less frequent. In-hospital mortality was higher for MUV as compared with single-valve procedures (2.4% versus 1.6%, P = .007). Preoperative independent predictors for mortality of patients undergoing MUV procedures were age, chronic obstructive pulmonary disease, diabetes mellitus, renal dysfunction, dialysis, congestive heart failure, cardiogenic shock, NYHA class III-IV, mitral stenosis, tricuspid regurgitation, mitral valve replacement, and concomitant CABG. However, risk factors for mortality were relatively different between single-valve and MUV procedures. Conclusion: Baseline characteristics and epidemiology were different between MUV and single-valve procedures. The in-hospital mortality and postoperative complications for MUV procedures remained considerably higher and determinants of mortality were relatively different across procedures types. These findings serve as a benchmark for further studies, as well as suggest a continued search for explanations of MUV outcomes.

scholarly journals Prevalence of Cardiovascular Events and Their Risk Factors in Patients With Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea Overlap Syndrome

2021 ◽  
Vol 8 ◽  
Author(s):  
Manyun Tang ◽  
Yunxiang Long ◽  
Shihong Liu ◽  
Xin Yue ◽  
Tao Shi
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Partial Pressure ◽  
Cardiovascular Events ◽  
Overlap Syndrome ◽  
Chronic Obstructive ◽  
Prevalence Rates ◽  
Obstructive Pulmonary Disease ◽  
Obstructive Sleep

Rationale: Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) have been identified as independent risk factors for cardiovascular diseases. However, the impact of COPD and OSA overlap syndrome (OS) on cardiovascular outcomes remains to be elucidated.Objective: To determine the prevalence of cardiovascular events and their risk factors in OS patients.Methods: Seventy-four patients who had OS between January 2015 and July 2020 were retrospectively enrolled, and 222 COPD-only patients and 222 OSA-only patients were pair-matched for age and sex from the same period and served as the OS-free control group. The prevalence rates of coronary heart disease (CHD), arrhythmia, heart failure, and pulmonary arterial hypertension (PAH) were compared among the three groups, and multivariable logistic regression models were used to screen the risk factors for specific cardiovascular events.Results: OS patients had higher prevalence rates of heart failure (10.8 vs. 0.5 and 1.4%, respectively) and PAH (31.1 vs. 4.5 and 17.1%, respectively) than those with OSA alone or COPD alone (all P < 0.01). The CHD prevalence was also significantly higher in the OS group than in the COPD-alone group (25.7 vs. 11.7%, P < 0.01). There was no significant difference in the prevalence of arrhythmia among the three groups (20.3, 22.5, and 13.1%, respectively, P > 0.05). In OS patients, risk factors for CHD included hypertension, diabetes, body mass index, lactate dehydrogenase level, and tidal volume; risk factors for heart failure included diabetes, partial pressure of oxygen, partial pressure of carbon dioxide, maximum ventilatory volume, and neutrophilic granulocyte percentage; and risk factors for PAH included minimum nocturnal oxygen saturation, partial pressure of carbon dioxide, and brain natriuretic peptide and lactate dehydrogenase levels.Conclusions: OS patients have a higher prevalence of cardiovascular events, which is associated with hypoxemia, hypercapnia, and impaired lung function in these patients.

scholarly journals Comorbidity of chronic heart failure and chronic obstructive pulmonary disease: features of pathogenesis, clinic and diagnostics

2018 ◽  
Vol 17 (6) ◽  
pp. 62-68 ◽  
Author(s):  
R. E. Tokmachev ◽  
M. S. Mukhortova ◽  
A. V. Budnevsky ◽  
E. V. Tokmachev ◽  
E. S. Ovsyannikov
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Chronic Heart Failure ◽  
Pulmonary Disease ◽  
Research Methods ◽  
Clinical Symptoms ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Common Risk Factors

This article discusses the epidemiology of chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD). CHF and COPD are characterized by high prevalence and high mortality, especially when they are combined. The article analyzes the general mechanisms of formation of these diseases: the relationship of COPD with cardiovascular diseases is explained by common risk factors, including smoking, physical inactivity, improper feeding and genetic predisposition. The leading role in the pathogenesis of pathologies is played by the activation and maintenance of systemic inflammation. Article presents the features of the clinical picture and the direction of the diagnostics in case of suspected combined pathology, the possibilities of modern laboratory and instrumental research methods. Diagnostics of comorbidity of CHF and COPD may be difficult, given the above common risk factors, some common pathogenesis mechanisms and similar clinical symptoms. However the caution regarding the comorbidity of the studied conditions, as well as a thorough clinical examination and the appointment of the necessary additional research methods, can reduce the number of diagnostic mistakes and improve the prognosis in such patients.

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