Differences in Biomarkers Pattern Between Severe Isolated Right and Left Ventricular Dysfunction After Cardiac Surgery

Abstract

Objective: To find out if there are any differences in biomarkers between severe isolated right ventricular (RV) dysfunction and severe isolated left ventricular (LV) dysfunction after cardiac surgery using cardiopulmonary bypass.

Design: Observational study.

Setting: Teaching hospital.

Participants: A total of 46 patients who had severe isolated RV or LV dysfunction after cardiac surgery.

Intervention: The authors collected perioperative clinical and biomarker data.

Measurements and main results: Severe isolated RV dysfunction patients (n = 20) had higher postoperative direct bilirubin (p = 0.030), total bilirubin (p = 0.044), glucose (p = 0.011), and international normalized ratio (INR) (p = 0.050) by repeated measure analysis of variance when compared with patients with severe isolated LV dysfunction (n = 26). The RV group also showed lower preoperative alanine transferase (19.3 ± 1.5 v 32.7 ± 4.2, p = 0.001), higher 4-hour INR (1.5 ± 0.3 v 1.4 ± 0.2, p = 0.008), and higher 48-hour INR (1.8 ± 0.4 v 1.4 ± 0.1, p < 0.001). None in the LV group died, whereas 4 patients in the RV group died (all of them had preoperative atrial fibrillation and underwent double valve replacement surgery).

Conclusion: The authors observed biomarkers differences between severe isolated RV dysfunction and severe isolated RV dysfunction.

Keywords: anesthesia; biomarker; cardiac dysfunction; cardiopulmonary bypass; intensive care; left ventricular failure; liver; right ventricular failure; ventricular dysfunction.