Incidence and risk factors of low cardiac output syndrome in patients after cardiac valve replacement
WANG Linning
LIU Chunming
YUAN Xiaowei
LIU Kuizhi
XUAN Xuexi
Abstract：Objective To discuss the incidence of low cardiac output syndrome(LCOS)and analyze its risk factors in patients after cardiac valve replacement,and provide basis for formulating targeted clinical prevention and interventional strategies.Methods A total of 148 patients was enrolled,who underwent cardiac valve replacement at the Seventh People's Hospital of Zhengzhou from Dec.2022 to Nov.2023.The number and incidence of postoperative LCOS were recorded.According to the occurrence of postoperative LCOS,the patients were divided into LCOS group and non-LCOS group.The general data,preoperative cardiac function,imaging indicators,laboratory indicators,surgery-related indicators,postoperative indicators and prognostic indicators were collected in 2 groups.The indicators with significant differences were screened by using univariate analysis,the independent high-risk factors for LCOS were identified by applied a multivariate Logistic regression model.The predictive efficacy of each independent high-risk factor for LCOS was analyzed by performing receiver operating characteristic(ROC)curve.Results Among the 148 patients,7 cases(4.73%)developed postoperative LCOS.The results of univariate analysis showed that there were statistically significant differences between LCOS group and non-LCOS group in terms of age,body mass index(BMI),complicated diabetes mellitus(DM),New York Heart Association(NYHA)cardiac function grade Ⅲ～Ⅳ,left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),pulmonary arterial hypertension(PAH),estimated glomerular filtration rate(eGFR),hemoglobin(Hb),albumin,surgical type,operation duration,cardiopulmonary bypass(CPB)time,aortic occlusion(AO)time,intraoperative blood transfusion volume,postoperative 24 h peak level of cardiac troponin I(cTnI),postoperative 6-h level of arterial blood lactic acid(LA),mechanical ventilation(MV)time,ICU stay time,postoperative hospital stay,30-d mortality and 30-d readmission rate(P<0.050).The results of Logistic regression analysis revealed that NYHA cardiac function grade Ⅲ～Ⅳ,decreased LVEF,PAH,prolonged CPB time and elevated postoperative 6-h level of arterial blood LA were independent risk factors for LCOS occurrence in patients after cardiac valve replacement(P<0.050).The results of ROC curve analysis indicated that the area under the curve(AUC)of the combined prediction of LCOS by the five indicators(NYHA cardiac function grade Ⅲ～Ⅳ,LVEF<48.5%,PAH,prolonged CPB time and elevated postoperative 6 h level of arterial blood LA)was 0.946,with a sensitivity of 92.9%and a specificity of 87.2%,and the predictive efficacy was superior to that of a single indicator.Conclusion The incidence of LCOS following cardiac valve replacement is relatively high with multiple risk factors involved.Notably,LCOS risk increases significantly when LVEF is less than 48.5%.Combining multiple independent risk factors can improve the predictive efficacy for LCOS.Targeted intervention measures should be actively implemented to reduce LCOS incidence and improve the prognosis of patients.
Keywords：cardiac valve replacementlow cardiac output syndromehigh-risk factorsperioperative management
Publication Date：2026-02-20
Online Publishing Date：2026-03-19(First online date of this platform, not the publication date of the document)
Pages：6( 162-167 )