alexa Cardiopulmonary Exercise Test In Cardiac Risk In Abdominal Surgery
ISSN: 2155-9880

Journal of Clinical & Experimental Cardiology
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16th World Cardiology Congress
December 08-10, 2016 Dubai, UAE

Peter Chomakhidze, Mozzhuhina N and Poltavskaya M
I M Sechenov First Moscow State Medical University, Russia
Posters & Accepted Abstracts: J Clin Exp Cardiolog
DOI: 10.4172/2155-9880.C1.063
Background: We have performed a cardiopulmonary exercise test (CPT) in 270 patients undergoing a major abdominal surgery (MAS). We analyzed the prognostic value of all CPT indexes in major cardiac complications (MCC), myocardial infarction (MI), stroke and cardiac death (CD) risk evaluation. Besides we analysed other cardiac complications (OCC) such as: angina, severe ventricular arrhythmia and atrial fibrillation episodes. Methods: 270 patients underwent CPT, performed a day before sugrery when all cardiac medications were optimized. We used tredmil test and modified Bruce protocol. The main indexes we analysed were: oxygen uptake (VO2), carbon dioxide output (VCO2), ventilation (VE), anaerobic threshold (AT), oxygen-pulse (O2-pulse) and breath reserve (BR). We have compared three groups of patients- those who underwent surgery with no cardiac complications (G-1), patients with major cardiac complications (G-2) and patients with OCC. Results: In 81 patients, we have detected 89 different cardiac complications. MCC: 18 MI (6.7%), six strokes (2.2%), six CD (2.2%). There was no benefit when CPT results were added to logistic-regression model in addition to routine preoperative examination of patients (AUC 0.84±0.05 vs. 0.86±0.05). Nevertheless BR and O2-pulse appeared to be independent predictors of major cardiac complications (AUC 0.83±0.04, p=0.01). There was also a significant difference between G-2 and other patients in AT level (15.2±3.6 vs. 10.1±3.9, p<0.01) and between G3 and other patients in AT level (17.2±2.8 vs. 13.2±3.1, p<0.001). Significant difference was found between G1 and all patients with different cardiac complications in exercise tolerance (4.2 METS vs. 5.6 METS, p=0.018), max oxygen uptake (14.3 ml/kg/min vs. 18.9 ml/kg/min, p=0.021) and in oxygen-pulse level (11.7 vs. 15.2, p=0.03). Conclusion: AT level, BR and O2-pulse are considered to be significant independent prognostic markers of MI and cardiac death. Exercise tolerance, max oxygen uptake and oxygen-pulse level are associated with major and minor cardiac complications in patients, undergoing major abdominal surgery.

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