Predictors of low cardiac output syndrome after combined mitral and tricuspid valve surgery.

Introduction: Low cardiac output syndrome (LCOS) is a common complication in cardiac surgery, and we evaluated the incidence of its early occurrence after mitral and tricuspid combined cardiac surgery and its associated risk factors. Material and method: Retrospective, single institution study. We included 88 consecutive adult patients with severe mitral insufficiency scheduled for elective mitral and tricuspid valve replacement surgery between January 2015 and November 2018. The primary endpoint was the occurrence of LCOS, defined as the need for inotropic support or circulatory assistance after surgery. The secondary endpoint was mortality at 30 days. Results: LCOS occurred in 26 patients (29.5%) of the studied patients and its associated risk factors that appeared in the multivariate analysis were chronic kidney failure [adjusted odds ratio (OR) 3.1; 95% confidence interval (CI) 1.0-9.9, p = 0.05], pre-operative left ventricular heart failure (OR 5.3; 95% CI 1.3-10.9, p = 0.002), pre-operative right ventricular heart failure (OR 3.6; 95% CI 1.1-11.5, p = 0.02), and mitral valve replacement (OR 3.9; 95% CI 1.2-12.6, p = 0.03). LCOS affected the survival of patients (HR = 5.5; 95% CI 1.1-27.7 p = 0.04). Conclusion: LCOS is a frequent complication after mitral and tricuspid combined surgery and is associated with poor prognosis.

Sports participation and myocarditis: Influence of sport types on disease severity.

OBJECTIVE: To study, in the context of acute myocarditis (AM) in sportsmen, the association between the category of sport practiced and the severity of AM. DESIGN: Retrospective study. SETTING: Single tertiary center. PATIENTS: 82 sportspeople (≥2.5 h of sport per week) who presented an AM. ASSESSMENT OF RISK FACTORS: The type of sport activity before AM were collected. MAIN OUTCOME MEASURES: Complicated AM was defined by a left ventricular ejection fraction <50% or the use of inotropic drugs or ventricular assist device. RESULTS: Mean age was 29 ± 9 year-old, 77 (94%) were men. Sixteen (20%) had a complicated AM. Practicing sport over 6 h a week or a Mitchell's Class IIIA sport were associated with complicated AM (44 vs. 17%, p = 0.019 and 38 vs. 11%, p = 0.008, respectively). Practicing a Mitchell's Class IC sport was associated with uncomplicated AM (6 vs. 38%, p = 0.008). CONCLUSION: In sportspeople's AM, the pattern of sport activity (static or dynamic component, practice intensity) is associated with the disease's severity.