Acute kidney injury after valvular heart surgery and early changes in cardiac function and structure.
BACKGROUND
Acute kidney injury (AKI) following heart surgery is associated with long-term risk of heart failure. It is not known if AKI following valvular heart surgery is associated with early changes in cardiac function or structure.


METHODS
A cohort study was conducted on 201 patients with AKI and 201 patients without AKI after valvular heart surgery, who were matched for age, sex, left ventricular function, and estimated glomerular filtration rate. AKI was defined as an increase in postoperative serum creatinine of ≥26 μmol/l (≥0.3 mg/dl) or a relative increase of ≥50%. The two primary outcomes were changes in post-compared with preoperative left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) assessed by echocardiography.


RESULTS
The mean age was 72 years, and 33% were female. Aortic valve surgery was the most frequent procedure. The mean time from surgery to the postoperative echocardiographic examination was 4.9 days (SD 3.7). There was no significant change in postoperative mean LVEF (-3.6 vs. -4.3%; p = 0.58) or mean LVEDD (-4.7 vs. -3.9 mm; p = 0.31) in patients with AKI compared to those without AKI.


CONCLUSIONS
We found no acute changes in cardiac function or structure assessed by echocardiography in patients with AKI compared to those without AKI after valvular heart surgery.
Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Daniel P
DP
Olsson
Department of Emergency Medicine, Karolinska Institutet, Stockholm, Sweden.
Christopher
C
Eck Arvstrand
Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
Ulrik
U
Sartipy
Department of Medicine, Karolinska Institutet, Stockholm, Sweden ; Department of Emergency Medicine, Karolinska Institutet, Stockholm, Sweden.
Martin J
MJ
Holzmann
Acute kidney injury; Cardiorenal syndrome; Echocardiography; Valvular heart surgery