Department of Out-Patient Care, Instituto National Institute of Cardiology Ignacio Chavez, Mexico City.
Fundación Clinical Medica Sur, Mexico City.
Arch Cardiol Mex. 2020;90(4):490-497. doi: 10.24875/ACM.20000129.
Overweight and obesity (O/O) generate lipotoxicity of the cardiac fiber and increase the incidence and progression of aortic valve stenosis. The low cardiac output syndrome (LCOS) is a timing complication after to aortic valve replacement (AVR) surgery.
The objective of the study was to investigate if body mass index (BMI) kg/m is a risk factor associated with LCOS and mortality in the post-operative period of AVR.
A historic cohort study was designed, including patients with severe aortic stenosis (SAS), who were subjected to AVR.
152 patients were included, 45 (29.6%), with normal weight (NW), 60 were overweight (39.5%), and 47 obese (30.9%). The prevalence of systemic hypertension (HT) was higher in O/O (p < 0.0001). Incidence of LCOS was 44.7%, being more frequent in the O/O groups compared to the NW group, 43.3%, 68.1%, and 22.2%, respectively, (p < 0.05 in overweight and p < 0.0001 in the obese). Assessing the presence or absence of LCOS associated with BMI as a numerical variable, we found that women, HT, BMI, left ventricular mass, and valve size, were associated with LCOS (p < 0.02, p < 0.02, p < 0.001, p < 0.032, and p < 0.045, respectively). Mortality was higher in patients who had LCOS (p < 0.02). Multivariate model showed that BMI was an independent risk factor for LCOS (odds ratio [OR] 1.21 [95% CI 1.08-1.35], p < 0.001).
BMI is a risk factor associated to LCOS in the post-operative period of AVR in patients with SAS.
超重和肥胖（O/O）会导致心肌纤维脂肪毒性，并增加主动脉瓣狭窄的发生率和进展。低心输出量综合征（LCOS）是主动脉瓣置换（AVR）手术后的时间并发症。
本研究旨在探讨体重指数（BMI）kg/m 是否是 AVR 术后 LCOS 和死亡率的相关危险因素。
设计了一项历史性队列研究，纳入了患有严重主动脉瓣狭窄（SAS）并接受 AVR 的患者。
共纳入 152 例患者，其中 45 例（29.6%）为正常体重（NW），60 例超重（39.5%），47 例肥胖（30.9%）。O/O 组的系统性高血压（HT）患病率更高（p < 0.0001）。LCOS 的发生率为 44.7%，O/O 组较 NW 组更常见，分别为 43.3%、68.1%和 22.2%（超重组 p < 0.05，肥胖组 p < 0.0001）。评估 BMI 作为数值变量的存在与否与 LCOS 的关系，我们发现女性、HT、BMI、左心室质量和瓣膜大小与 LCOS 相关（p < 0.02、p < 0.02、p < 0.001、p < 0.032 和 p < 0.045）。患有 LCOS 的患者死亡率更高（p < 0.02）。多变量模型显示 BMI 是 LCOS 的独立危险因素（优势比 [OR] 1.21 [95% CI 1.08-1.35]，p < 0.001）。
在 SAS 患者的 AVR 术后期间，BMI 是 LCOS 的一个相关危险因素。
