title: [Plasmatic pattern and clinical outcomes of lactic acid in heart transplantation].
abstract: BACKGROUND
  It is not well established the prognostic value of elevated lactic acid after heart transplantation.
  
  
  OBJECTIVE
  To evaluate the plasmatic pattern and the prognostic value of elevated lactate after heart transplantation.
  
  
  METHODS
  One-hundred and twenty seven patients were included between 2011 and 2014, 71 comprising the transplantation group and 56 the control group, represented by on pump coronary artery by-pass surgery patients. Lactic acid levels were compared between groups before, within and after surgery upon Coronary Care Unit admission, at 6, 12 and 24h. In addition, in the transplantation group univariate and bivariate analysis were performed between lactic acid levels and in-hospital mortality.
  
  
  RESULTS
  The mean age of the entire cohort was 57 years. Among transplanted patients, lactic acid levels were significantly higher over control group: within the surgery; and after surgery (P<.001), but not before surgery (P=.143; unadjusted comparisons). In transplanted patients, lactic acid levels were significantly associated with in-hospital mortality during surgery, at admission, and thereafter but not before surgery. Lactic acid at admission was associated with in-hospital mortality after adjustment of postoperative cardiac output (P=.011),≥2 inotropic drug support within 24h (P=.033), glycemic level at admission (P=.004), age≥60 years (P=.015), on pump time (P=.027), and pH (P=.017).
  
  
  CONCLUSIONS
  Acid lactic levels were higher in transplanted patients than in the control group and was associated to higher in-hospital mortality.
authors.affiliation: Servicio de Cardiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. Electronic address: anibal.arias@hospitalitaliano.org.ar.
authors.forename: Aníbal M
authors.initials: AM
authors.lastname: Arias
authors.affiliation: Servicio de Cardiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Vanina
authors.initials: V
authors.lastname: Leyendecker
authors.affiliation: Servicio de Cardiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Pizarro
authors.affiliation: Servicio de Cardiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Luciano
authors.initials: L
authors.lastname: Lucas
authors.affiliation: Servicio de Cardiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Norberto
authors.initials: N
authors.lastname: Vulcano
authors.affiliation: Servicio de Cirugía Cardiovascular, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Ricardo G
authors.initials: RG
authors.lastname: Marenchino
authors.affiliation: Servicio de Cardiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Santiago
authors.initials: S
authors.lastname: Del Castillo
authors.affiliation: Servicio de Cardiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Arturo M
authors.initials: AM
authors.lastname: Cagide
authors.affiliation: Servicio de Cardiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Cesar A
authors.initials: CA
authors.lastname: Belziti
mesh_terms: D000368:Aged; D005260:Female; D016027:Heart Transplantation / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D019344:Lactic Acid
keywords: Argentina; Heart failure; Heart transplantation; Insuficiencia cardíaca; Lactic acid; Trasplante cardíaco; Ácido láctico