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Background <p>To identify the clinical manifestations, predictors, early markers and potential pathophysiological mechanisms associated with the development of low cardiac output syndrome (LCOS) after cardiac valve replacement (CVR) surgery.</p> Methods <p>A retrospective analysis of prospectively collected data from the hospital’s clinical research database. Between February 2020 and April 2024, 105 patients who underwent CVR were included based on diagnostic criteria and data integrity. Stepwise logistic regression was used to identify independent predictors and early markers for LCOS and prolonged hospital stay.</p> Results <p>The overall prevalence of LCOS was 28%. Multivariate regression analysis identified the predictors for LCOS as a lower preoperative ejection fraction (OR: 0.917), and early markers as a immediate postoperative higher lymphocyte count (OR: 7.462) and a lower hematocrit (OR: 0.88). Additionally, lower hemoglobin concentration (B: -0.038, <i>P</i> = 0.004) and reduced high-density lipoprotein (HDL) level (B: -1.573, <i>P</i> = 0.039) were each independently associated with increased risk of LCOS. Conversely, elevated C-reactive protein (CRP) (B: 0.011, <i>P</i> = 0.01) and lactate dehydrogenase (LDH) concentrations (B: 0.002, <i>P</i> = 0.046) were independently associated with higher LCOS incidence. Patients with LCOS exhibited significantly longer duration of hospitalization compared to those without LCOS (34.2 versus 24.8 days, <i>P</i> &lt; 0.01). Furthermore, LCOS patients were characterized by older age, higher utilization of positive inotropic drugs, significantly lower HDL levels (0.9 versus 1.0 mmol/L, <i>P</i> = 0.036), and markedly elevated CRP concentrations (79.1 versus 44.4&#xa0;mg/L, <i>P</i> = 0.012).</p> Conclusions <p>LCOS is significantly associated with increased morbidity and prolonged hospitalization. Strategies such as inhibiting systemic inflammation, optimizing hemorheological parameters, and preserving cardiac function may potentially reduce the incidence of LCOS, thereby improving postoperative outcomes after CVR.</p>

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Clinical manifestations, predictors, early markers and potential mechanisms associated with low cardiac output syndrome after cardiac valve replacement

  • 期刊论文

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  • 发表日期：

    2026年4月29日

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  • Yuting Huang,
  • Jianqun Hu,
  • Xuemei Lan,
  • Danqi Guo,
  • Jiaxin Chen,
  • Junjian Yu,
  • Yaxuan Zhong,
  • Chengnan Tian,
  • Wentong Li,
  • Ziyou Liu

摘要

Background

To identify the clinical manifestations, predictors, early markers and potential pathophysiological mechanisms associated with the development of low cardiac output syndrome (LCOS) after cardiac valve replacement (CVR) surgery.

Methods

A retrospective analysis of prospectively collected data from the hospital’s clinical research database. Between February 2020 and April 2024, 105 patients who underwent CVR were included based on diagnostic criteria and data integrity. Stepwise logistic regression was used to identify independent predictors and early markers for LCOS and prolonged hospital stay.

Results

The overall prevalence of LCOS was 28%. Multivariate regression analysis identified the predictors for LCOS as a lower preoperative ejection fraction (OR: 0.917), and early markers as a immediate postoperative higher lymphocyte count (OR: 7.462) and a lower hematocrit (OR: 0.88). Additionally, lower hemoglobin concentration (B: -0.038, P = 0.004) and reduced high-density lipoprotein (HDL) level (B: -1.573, P = 0.039) were each independently associated with increased risk of LCOS. Conversely, elevated C-reactive protein (CRP) (B: 0.011, P = 0.01) and lactate dehydrogenase (LDH) concentrations (B: 0.002, P = 0.046) were independently associated with higher LCOS incidence. Patients with LCOS exhibited significantly longer duration of hospitalization compared to those without LCOS (34.2 versus 24.8 days, P < 0.01). Furthermore, LCOS patients were characterized by older age, higher utilization of positive inotropic drugs, significantly lower HDL levels (0.9 versus 1.0 mmol/L, P = 0.036), and markedly elevated CRP concentrations (79.1 versus 44.4 mg/L, P = 0.012).

Conclusions

LCOS is significantly associated with increased morbidity and prolonged hospitalization. Strategies such as inhibiting systemic inflammation, optimizing hemorheological parameters, and preserving cardiac function may potentially reduce the incidence of LCOS, thereby improving postoperative outcomes after CVR.