Department of Cardiology, The Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, No.366 Taishan Street, Taian, 271000, People's Republic of China.
Department of Cardiology, Linyi People's Hospital, Linyi, People's Republic of China.
Sci Rep. 2024 Feb 15;14(1):3782. doi: 10.1038/s41598-024-54220-8.
Cardiovascular complications in patients undergoing thoracic surgery, which physicians have a limited ability to predict, are often unavoidable and resulting in adverse outcome. Cardiopulmonary exercise testing (CPET), the gold standard of cardiopulmonary function evaluation, has also been proved to be a preoperative risk assessment tool. Meanwhile, elevated red blood cell distribution width (RDW) has surged as a biochemical marker in the occurrence of cardiovascular disease. However, it is yet unclear the value of CPET combined with RDW in predicting cardiovascular complications after thoracic surgery. 50 patients with cardiovascular complications after thoracic surgery were collected as the case group, and 100 thoracic surgery patients were recruited as the control group, with the same gender, age ± 2 years old, and no postoperative complications. After admission, all patients underwent CPET and RDW inspection before surgery, and the results were recorded. The CPET parameter oxygen pulse (VO/HR) and RDW of the case group were lower than those of the control group (P < 0.05), and the ventilation/carbon dioxide production (VE/VCO slope) was significantly higher than control group (P < 0.01). The biochemical parameters hemoglobin (Hb) and Glomerular filtration rate (GFR)) of the case group were lower than those of the control group (P < 0.05), the homocysteine (hCY), creatinine (Cr), operation time and blood loss of the case group were higher than those of the control group (P < 0.05). The RDW had a negative correlation with VO max in both overall and control group. The combination of VO/kg and RDW had the highest diagnostic value in predicting cardiovascular complications. The combination of VO/kg and RDW has predictive diagnostic value and is more suitable for predicting postoperative complications of thoracic surgery.
胸外科患者的心血管并发症，医生对此预测能力有限，往往难以避免，并导致不良后果。心肺运动测试（CPET）是心肺功能评估的金标准，也已被证明是一种术前风险评估工具。同时，红细胞分布宽度（RDW）升高已成为心血管疾病发生的生化标志物。然而，CPET 联合 RDW 预测胸外科手术后心血管并发症的价值尚不清楚。收集了 50 例胸外科手术后发生心血管并发症的患者作为病例组，另招募 100 例胸外科患者作为对照组，性别相同，年龄相差±2 岁，且无术后并发症。入院后，所有患者均在术前进行 CPET 和 RDW 检查，并记录结果。病例组的 CPET 参数氧脉搏（VO/HR）和 RDW 低于对照组（P<0.05），通气/二氧化碳产生（VE/VCO 斜率）明显高于对照组（P<0.01）。病例组的生化参数血红蛋白（Hb）和肾小球滤过率（GFR）均低于对照组（P<0.05），病例组的同型半胱氨酸（hCY）、肌酐（Cr）、手术时间和出血量均高于对照组（P<0.05）。RDW 与总体和对照组的 VO max 呈负相关。VO/kg 和 RDW 的组合在预测心血管并发症方面具有最高的诊断价值。VO/kg 和 RDW 的组合具有预测诊断价值，更适合预测胸外科手术后的并发症。
