Details

Autor(en) / Beteiligte

• Papazisi, Olga
• van Vessem, Marieke E
• Beeres, Saskia L
• de Wilde, Rob B
• Berendsen, Remco R
• de Jonge, Evert
• Robert, Klautz J
• Aarts, Leon P
• Schalij, Martin J
• Palmen, Meindert

Titel

Abstract 15823: Diminished Vasoresponsiveness in Patients With Heart Failure

Ist Teil von

• Circulation (New York, N.Y.), 2020-11, Vol.142 (Suppl_3 Suppl 3), p.A15823-A15823

Ort / Verlag

by the American College of Cardiology Foundation and the American Heart Association, Inc

Erscheinungsjahr

2020

Link zum Volltext

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• IntroductionVasoplegia is a severe complication after cardiac surgery and is associated with impaired clinical outcome. Pre-operative heart failure (HF) is considered an independent predictor of post-operative vasoplegia. We hypothesize that HF patients are more susceptible to vasoplegia due to altered vascular responsiveness. In this study, vasoresponsiveness in patients undergoing cardiac surgery for HF is investigated.MethodsA prospective, observational study was conducted at Leiden University Medical Center. We included patients with HF (N=18) and without HF (N=18) who underwent cardiac surgery on cardiopulmonary bypass. Vasoresponsiveness was assessed at 4 different timepoints1) before induction, 2) after induction, 3) after cessation of cardiopulmonary bypass and 4) on the first postoperative day. The vascular response was recorded as change in systemic vascular resistance (SVR) after the administration of phenylephrine (bolus 2 μg/kg).ResultsThirty-six patients were included [67 (61-71) years, 78% male]. Vascular responsiveness was significantly attenuated in patients with HF compared to controls. The response to phenylephrine was already diminished at baseline in HF patients and was almost abolished after cessation of cardiopulmonary bypass (Figure). Roughly the same pattern of vasoresponsiveness was found when excluding patients that received norepinephrine. Moreover, HF patients required a significantly higher amount of noradrenaline [169.80 (IQR 14.77-318.97) ug/kg] compared to controls [3.61 (IQR 0-41.60) ug/kg] to maintain similar SVR during the first 24h postoperatively.ConclusionsThe vascular responsiveness is altered in patients with HF and this might explain the higher prevalence of vasoplegia in this patient population.