Clinical and functional profile of patients with chronic thromboembolic pulmonary hypertension and early postoperative atrial fibrillation

Klinkova AS, Kamenskaya OV, Loginova IYu, et al. . Clinical and functional profile of patients with chronic thromboembolic pulmonary hypertension and early postoperative atrial fibrillation. Russian Journal of Cardiology and Cardiovascular Surgery. 2023;16(5):522‑528. (In Russ.)
https://doi.org/10.17116/kardio202316051522

Подписка 2025-2 (Russian Journal of Cardiology and Cardiovascular Surgery)

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OBJECTIVE

To study the clinical and functional profile of patients with chronic thromboembolic pulmonary hypertension (CTEPH) and early postoperative atrial fibrillation (AF).

MATERIAL AND METHODS

The study included 134 patients with CTEPH who admitted for surgical treatment (thromboendarterectomy). Mean age was 53.7 (43.8—67.3) years. The 1st group (26 people) consisted of patients with first-time AF in early postoperative period, the 2nd group (108 people) — those without AF. Preoperative echocardiography data, clinical and anamnestic data, intraoperative parameters and early postoperative complications were analyzed.

RESULTS

The 1st group was characterized by older age (p=0.001), prevalence of chronic heart failure NYHA class III (p=0.029) and concomitant chronic kidney disease (p=0.008), higher Charlson comorbidity index (p=0.001). In both groups, both atria were enlarged with predominance of longitudinal dimensions of the left atrium (p=0.01) and higher pulmonary artery pressure (p=0.01) in the 1st group. There were more patients with postoperative encephalopathy (p<0.001), pulmonary and heart failure (p=0.01), multiple organ failure (p=0.03) in the 1st group. Moreover, prolonged mechanical ventilation (p<0.001) and hospital-stay (p<0.001) were more common.

CONCLUSION

CTEPH patients with early postoperative AF are characterized by more severe structural and functional changes of cardiac chambers, older age, more severe underlying and concomitant diseases. AF in CTEPH patients is associated with more severe postoperative course, prolonged mechanical ventilation and hospital-stay.

Keywords:

chronic thromboembolic pulmonary hypertension

atrial fibrillation

Authors:

Klinkova A.S.

Meshalkin National Medical Research Center

ORCID: 0000-0003-2845-930X

Kamenskaya O.V.

Meshalkin National Medical Research Center

ORCID: 0000-0001-8488-0858

Loginova I.Yu.

Meshalkin National Medical Research Center

ORCID: 0000-0002-3219-0107

Porotnikova S.S.

Meshalkin National Medical Research Center

ORCID: 0000-0002-0061-2205

Lomivorotov V.N.

Meshalkin National Medical Research Center

ORCID: 0000-0003-2399-563X

Lomivorotov V.V.

Meshalkin National Medical Research Center;
Novosibirsk State University

ORCID: 0000-0001-8591-6461

Volkova I.I.

Meshalkin National Medical Research Center

ORCID: 0000-0001-6575-9008

Chernyavskii A.M.

E.N. Meshalkin National Medical Research Center

ORCID: 0000-0001-9818-8678

Received:

06.12.2022

Accepted:

09.02.2023

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