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Influence of increased left ventricular myocardial mass on early and late mortality after cardiac surgery
British Journal of Anesthesia, 08/10/2012
Clinical Article
Weiner MM et al. – Increased left ventricular mass index (LVMI), but not LV systolic function as measured by the fractional area of contraction (FAC) was identified as a strong independent predictor of perioperative mortality after adult cardiac surgery. The relationship between LVMI and risk of 30day mortality was nearly linear. Furthermore, decreased FAC, and not LVMI, was a strong independent predictor of 1yr mortality.
Methods- With IRB approval, intraoperative transoesophageal echocardiography images of 844 cardiac surgical patients were reviewed.
- LVMI was calculated using the American Society of Echocardiography recommended formula.
- Outcome variables studied were 30day and 1yr mortality.
- Mortality within 30days occurred in 28 patients (3.3%) and within 1yr in 91 patients (10.8%).
- An almost linear relationship was found between increasing LVMI and the risk of mortality within 30days of cardiac surgery.
- The odds ratio (OR) of dying within 30days of surgery was 1.15 (95% confidence interval 1.01–1.31) per 20gm-2 increase in LVMI.
- This finding remained statistically significant in multivariate analysis controlling for the effects of age, weight, gender, surgery type, LV function, and functional status [OR=1.36 (1.11–1.66) per 20gm-2 increase].
- Increased LVMI was not found to be a statistically significant predictor of 1yr mortality.