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Physical performance as a predictor of midterm outcome after mitral valve surgery

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Abstract

The usefulness of performing physical function assessments for evaluating clinical outcomes after all cardiac surgeries has been reported. However, no studies have evaluated the relationship between physical function and prognosis in patients undergoing cardiac open surgery with mitral valve regurgitation (MR). This study investigated whether physical assessment, such as the short physical performance battery (SPPB), could predict unplanned readmission events in patients undergoing mitral valve surgery due to MR. SPPB could predict unplanned admission events in patients undergoing mitral valve surgery due to MR. This retrospective study included 168 patients who underwent mitral valve surgery. SPPB was performed 1.6 ± 1.1 days before surgery. The primary endpoint was unplanned readmission. The mean follow-up period was 762 ± 480 days, mean age was 73.8 ± 6.3 years, and 43% of the patients were women. Of the study patients, 46 required unplanned readmissions; 29 of these patients required readmissions within 1 year. Multivariate Cox regression analysis demonstrated that SPPB was independently associated with the primary endpoint. Receiver-operating characteristic analysis showed that SPPB had an area under the curve of 0.71, with an optimal cutoff of 11. The study patients were stratified into SPPB 12 or SPPB ≤ 11 groups. Kaplan–Meier analysis showed that the event-free rate was significantly lower in the SPPB ≤ 11 group (hazard ratio 3.8, 95% confidence interval 2.1–7.0; p < 0.001). SPPB was a useful tool for predicting unplanned readmission in patients undergoing mitral valve surgery due to MR.

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References

  1. O'Brien SM, Shahian DM, Filardo G, Ferraris VA, Haan CK, Rich JB, Normand SL, DeLong ER, Shewan CM, Dokholyan RS, Peterson ED, Edwards FH, Anderson RP, Society of Thoracic Surgeons Quality Measurement Task Force (2009) The Society of Thoracic Surgeons 2008 cardiac surgery risk models: part 2-isolated valve surgery. Ann Thorac Surg 88(1 Suppl):S23–42

    Article  PubMed  Google Scholar 

  2. Roques F, Michel P, Goldstone AR, Nashef SA (2003) The Logistic EuroSCORE. Eur Heart J 24:881–882

    Article  CAS  PubMed  Google Scholar 

  3. Lee DH, Buth KJ, Martin BJ, Yip AM, Hirsch GM (2010) Frail patients are at increased risk for mortality and prolonged institutional care after cardiac surgery. Circulation 121:973–978

    Article  PubMed  Google Scholar 

  4. Sepehri A, Beggs T, Hassan A, Rigatto C, Shaw-Daigle C, Tangri N, Arora RC (2014) The impact of frailty on outcomes after cardiac surgery: a systematic review. J Thorac Cardiovasc Surg 148:3110–3117

    Article  PubMed  Google Scholar 

  5. Saji M, Higuchi R, Tobaru T, Iguchi N, Takanashi S, Takayama M, Isobe M (2018) Impact of frailty markers for unplanned hospital readmission following transcatheter aortic valve implantation. Circ J 82:2191–2198

    Article  PubMed  Google Scholar 

  6. Guralnik JM, Ferrucci L, Simonsick EM, Salive ME, Wallace RB (1995) Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med 332:556–561

    Article  CAS  PubMed  Google Scholar 

  7. Volpato S, Cavalieri M, Guerra G, Sioulis F, Ranzini M, Maraldi C, Fellin R, Guralnik JM (2008) Performance-based functional assessment in older hospitalized patients: feasibility and clinical correlates. J Gerontol A Biol Sci Med Sci 63:1393–1398

    Article  PubMed  PubMed Central  Google Scholar 

  8. Chiarantini D, Volpato S, Sioulis F, Bartalucci F, Del Bianco L, Mangani I, Pepe G, Tarantini F, Berni A, Marchionni N, Di Bari M (2010) Lower extremity performance measures predict long-term prognosis in older patients hospitalized for heart failure. J Card Fail 16:390–395

    Article  PubMed  Google Scholar 

  9. Volpato S, Cavalieri M, Sioulis F, Guerra G, Maraldi C, Zuliani G, Fellin R, Guralnik JM (2011) Predictive value of the short physical performance battery following hospitalization in older patients. J Gerontol A Biol Sci Med Sci 66:89–96

    Article  PubMed  Google Scholar 

  10. Pavasini R, Guralnnnik J, Brown CJ, Bari M, Cesari M, Landi F, Vaes B, Legrand D, Verghese J, Wang C, Stenholm S, Ferrucci L, Lai CJ, Bartes AA, Espaulella J, Ferrer M, Lim YJ, Ensrud EK, Cawthon P, Turusheva A, Frolova E, Rolland Y, Lauwers V, Corsonello A, Kirk DG, Ferrari1 R, Volpato S, Campo G, (2016) Short physical performance battery and all-cause mortality: systematic review and meta-analysis. BMC Med 14:215

    Article  PubMed  PubMed Central  Google Scholar 

  11. Lytwyn J, Stammers AN, Kehler DS, Jung P, Alexander B, Hiebert BM, Dubiel C, Kimber D, Hamm N, Clarke M, Fraser C, Pedreira B, Duhamel TA, Tangri N, Arora RC (2017) The impact of frailty on functional survival in patients 1 year after cardiac surgery. J Thorac Cardiovasc Surg 154:1990–1999

    Google Scholar 

  12. Afilalo J, Lauck S, Kim DH, Lefèvre T, Piazza N, Lachapelle K, Martucci G, Lamy A, Labinaz M, Peterson MD, Arora RC, Noiseux N, Rassi A, Palacios IF, Généreux P, Lindman BR, Asgar AW, Kim CA, Trnkus A, Morais JA, Langlois Y, Rudski LG, Morin JF, Popma JJ, Webb JG, Perrault LP (2017) Frailty in older adults undergoing aortic valve replacement: the FRAILTY-AVR study. J Am Coll Cardiol 70:689–700

    Article  PubMed  Google Scholar 

  13. McDermott MM, Greenland P, Liu K, Guralnik JM, Criqui MH, Dolan NC, Chan C, Celic L, Pearce WH, Schneider JR, Sharma L, Clark E, Gibson D, Martin GJ (2001) Leg symptoms in peripheral arterial disease: associated clinical characteristics and functional impairment. JAMA 286:1599–1606

    Article  CAS  PubMed  Google Scholar 

  14. Nombela-Franco L, del Trigo M, Morrison-Polo G, Veiga G, Jimenez-Quevedo P, Abdul-Jawad Altisent O, Campelo-Parada F, Biagioni C, Puri R, DeLarochellière R, Dumont E, Doyle D, Paradis JM, Quirós A, Almeria C, Gonzalo N, Nuñez-Gil I, Salinas P, Mohammadi S, Escaned J, Fernández-Ortiz A, Macaya C, Rodés-Cabau J (2015) Incidence, causes, and predictors of early (≤ 30 days) and late unplanned hospital readmissions after transcatheter aortic valve replacement. JACC Cardiovasc Interv 8:1748–1757

    Article  PubMed  Google Scholar 

  15. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K (2013) Frailty in elderly people. Lancet 381:752–762

    Article  Google Scholar 

  16. Fontana L, Addante F, Copetti M, Paroni G, Fontana A, Sancarlo D, Pellegrini F, Ferrucci L, Pilotto A (2013) Identification of a metabolic signature for multidimensional impairment and mortality risk in hospitalized older patients. Aging Cell 12:459–466

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Sergi G, Veronese N, Fontana L, De Rui M, Bolzetta F, Zambon S, Corti MC, Baggio G, Toffanello ED, Crepaldi G, Perissinotto E, Manzato E (2015) Pre-frailty and risk of cardiovascular disease in elderly men and women: the Pro.V.A. study. J Am Coll Cardiol 65:976–983

    Article  PubMed  Google Scholar 

  18. Veronese N, Stubbs B, Fontana L, Trevisan C, Bolzetta F, Rui M, Sartori L, Musacchio E, Zambon S, Maggi S, Perissinotto E, Corti MC, Crepaldi G, Manzato E, Sergi G (2017) A Comparison of objective physical performance tests and future mortality in the elderly people. J Gerontol A Biol Sci Med Sci 72:362–368

    PubMed  Google Scholar 

  19. Afilalo J, Alexander KP, Mack MJ, Maurer MS, Green P, Allen LA, Popma JJ, Ferrucci L, Forman DE (2014) Frailty assessment in the cardiovascular care of older adults. J Am Coll Cardiol 63:747–762

    Article  PubMed  Google Scholar 

  20. Needham DM (2008) Mobilizing patients in the intensive care unit: improving neuromuscular weakness and physical function. JAMA 300:1685–1690

    Article  CAS  PubMed  Google Scholar 

  21. Binder EF, Yarasheski KE, Steger-May K, Sinacore DR, Brown M, Schechtman KB, Holloszy JO (2005) Effects of progressive resistance training on body composition in frail older adults: results of a randomized, controlled trial. J Gerontol A Biol Sci Med Sci 60:1425–1431

    Article  PubMed  Google Scholar 

  22. Kircher TT, Wormstall H, Müller PH, Ershoff DH, Wolde-Tsadik G, Rubenstein LZ, Ambrosini VL, Fishman LK, Beck JC (2007) A randomized trial of a geriatric evaluation and management consultation services in frail hospitalized patients. Age Ageing 36:36–42

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors would like to thank Mr. Kentaro Hori, PT, and all members of the rehabilitation room at the Sakakibara Heart Institute.

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Authors and Affiliations

  1. Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahicho, Fuchu, 183-0003, Tokyo, Japan

    Kohei Ashikaga, Mike Saji, Masatoshi Nagayama & Mitsuaki Isobe

  2. Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan

    Kohei Ashikaga & Yoshihiro J. Akashi

  3. Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan

    Shuichiro Takanashi

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  1. Kohei Ashikaga
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  2. Mike Saji
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  3. Shuichiro Takanashi
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  5. Yoshihiro J. Akashi
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  6. Mitsuaki Isobe
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Correspondence to Mike Saji.

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Ashikaga, K., Saji, M., Takanashi, S. et al. Physical performance as a predictor of midterm outcome after mitral valve surgery. Heart Vessels 34, 1665–1673 (2019). https://doi.org/10.1007/s00380-019-01397-y

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  • DOI: https://doi.org/10.1007/s00380-019-01397-y

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