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P Sh Chomakhidze1, N V Mozzhuhina, M G Poltavskaya

  • 1Sechenov First Moscow State Medical University (Sechenov University). Petr7747@gmail.com.

Kardiologiia
|February 4, 2019
PubMed
Summary

Cardiac complications pose a significant risk during abdominal surgery for older patients. Advanced cardiac functional examinations like echocardiography and ergospirometry improve risk stratification for better patient outcomes.

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Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Surgical Risk Assessment

Background:

  • Planned abdominal surgeries in patients over 65 or with cardiac conditions carry a notable risk of cardiovascular complications.
  • Effective risk stratification is crucial for optimizing perioperative management and patient safety.

Purpose of the Study:

  • To evaluate the utility of cardiac functional examination methods in stratifying cardiovascular complication risk.
  • To identify key predictors of perioperative major adverse cardiac events (MACE) in this patient cohort.

Main Methods:

  • A study involving 179 patients (median age 70) undergoing elective abdominal surgery.
  • Included basic assessments (ECG, blood tests) and advanced methods: echocardiography (EchoCG) and ergospirometry (ESM).
  • Cardiac complications were monitored during and for 30 days post-operation.

Main Results:

  • 16.8% of patients experienced cardiac complications, including myocardial infarction, stroke, and cardiac death.
  • Factors associated with complications included COPD, colon surgery, low hemoglobin, high creatinine, and resting ECG abnormalities.
  • EchoCG findings (LV outflow tract VTI, left atrial volume, LV myocardial deformation) and ESM results (heart rate increase, peak oxygen consumption) were significant predictors.

Conclusions:

  • The perioperative MACE risk is substantial (16.8%) in this high-risk group.
  • Echocardiography (assessing LV outflow tract VTI and myocardial deformation) and ESM (evaluating heart rate response and peak oxygen consumption) are recommended for enhanced risk assessment.
  • Tailored preoperative examination plans, considering sex, are suggested for optimal risk stratification.

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