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  2. Keyword: Fragility
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IJCS
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Frailty in Patients With Valve Disease: How to Assess?

David Provenzale Titinger et al. Vitor Emer Egypto Rosa Marcelo Eidi Ochiai Tarso Augusto Accorsi … João Ricardo Cordeiro Fernandes Roney Orismar Sampaio Flávio Tarasoutchi

Introduction

Valvular heart disease contributes to an important portion of hospital admissions. It can progress to heart failure and death, and it ranks eighth among the causes of mortality due to cardiovascular diseases in Brazil. From the moment that a valve disease becomes anatomically important and has clinical repercussions, only interventional treatment (conventional surgery or transcatheter technique) is able to alter the natural course of the disease., The choice of intervention leads to the need for individualized evaluation of the patient, exposing associated clinical conditions that may impact the final result, such as frailty.,

Frailty, as a clinical syndrome, is characterized by decreased physiological reserve and reduced capacity after a stressor event, causing vulnerability to diseases. It is related to decreased muscle strength, resistance, and functionality, resulting in greater dependence for daily activities and increased mortality. Some commonly associated conditions include sarcopenia, malnutrition, and hormonal disorders.

[…]

  • Aged
  • Fragility
  • Heart Valve Diseases
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Creative Commons Attribution (CC BY) Creative Commons license
03/03/2023 DOI: 10.36660/ijcs.20210277 Views 1
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Case Report

Systematic Staged Percutaneous Balloon Pulmonary Angioplasty in Severe Inoperable Chronic Thromboembolic Pulmonary Hypertension

Kazuhiro Dan et al. Akira Shionoda Hiromi Matsubara

Introduction

The treatment for chronic thromboembolic pulmonary hypertension (CTEPH) is limited to pulmonary endarterectomy (PEA), drug therapy, and percutaneous balloon pulmonary angioplasty (BPA). The gold-standard treatment is PEA, and patients with CTEPH and proximal lesions are generally good surgical candidates. Perioperative complications and persistent pulmonary hypertension due to incomplete endarterectomy or secondary vasculopathy are typical problems after the procedure. A meta-analysis has shown that the efficacy of drug therapy for severe CTEPH is limited, and many patients do not achieve sufficiently reduced pulmonary artery (PA) pressure, even if exercise tolerance is marginally improved. Percutaneous BPA was first reported in 2001, but its safety was not proven at that time. As recently as one decade ago, pulmonary hypertension was first associated with poor prognosis. Fortunately, treatments for pulmonary hypertension have dramatically improved ever since, particularly for patients with CTEPH. BPA is still a challenging strategy, limited to a specific operator and facility, but its results have been improving.

[…]

  • aging
  • Angioplasty, Balloon, Pulmonary
  • Fragility
  • Hypertension Pulmonary
  • Pulmonary embolism
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Creative Commons Attribution (CC BY) Creative Commons license
05/02/2021 DOI: 10.36660/abc.20190717 Views 2
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Original Article

Pre-Frailty Increases the Risk of Adverse Events in Older Patients Undergoing Cardiovascular Surgery

Miguel K. Rodrigues et al. Artur Marques Denise M. L. Lobo Iracema I. K. Umeda Mayron F. Oliveira

Abstract

Background:

Frailty is identified as a major predictor of adverse outcomes in older surgical patients. However, the outcomes in pre-frail patients after cardiovascular surgery remain unknown.

Objective:

To investigate the main outcomes (length of stay, mechanical ventilation time, stroke and in-hospital death) in pre-frail patients in comparison with no-frail patients after cardiovascular surgery.

Methods:

221 patients over 65 years old, with established diagnosis of myocardial infarction or valve disease were enrolled. Patients were evaluated by Clinical Frailty Score (CFS) before surgery and allocated into 2 groups: no-frailty (CFS 1~3) vs. pre-frailty (CFS 4) and followed up for main outcomes. For all analysis, the statistical significance was set at 5% (p < 0.05).

Results:

No differences were found in anthropometric and demographic data between groups (p > 0.05). Pre-frail patients showed a longer mechanical ventilation time (193 ± 37 vs. 29 ± 7 hours; p<0.05) than no-frail patients; similar results were observed for length of stay at the intensive care unit (5 ± 1 vs. 3 ± 1 days; p < 0.05) and total time of hospitalization (12 ± 5 vs. 9 ± 3 days; p < 0.05). In addition, the pre-frail group had a higher number of adverse events (stroke 8.3% vs. 3.9%; in-hospital death 21.5% vs. 7.8%; p < 0.05) with an increased risk for development stroke (OR: 2.139, 95% CI: 0.622-7.351, p = 0.001; HR: 2.763, 95%CI: 1.206-6.331, p = 0.0001) and in-hospital death (OR: 1.809, 95% CI: 1.286-2.546, p = 0.001; HR: 1.830, 95% CI: 1.476-2.269, p = 0.0001). Moreover, higher number of pre-frail patients required homecare services than no-frail patients (46.5% vs. 0%; p < 0.05).

Conclusion:

Patients with pre-frailty showed longer mechanical ventilation time and hospital stay with an increased risk for cardiovascular events compared with no-frail patients.

  • Adverse Events
  • aging
  • Cardiovascular Surgery
  • Fragility
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04/09/2017 DOI: 10.5935/abc.20170131 Views 1

How to cite this article

EndNote RIS

Electronic Document Format (Vancouver)

Titinger DP, Rosa VEE, Ochiai ME, Accorsi TA, Fernandes JRC, Sampaio RO, Tarasoutchi F, et al. Frailty in Patients With Valve Disease: How to Assess?. International Journal of Cardiovascular Sciences 2023;36:e20210277.

Electronic Document Format (ABNT)

Titinger, David Provenzale; Rosa, Vitor Emer Egypto; Ochiai, Marcelo Eidi; Accorsi, Tarso Augusto; Fernandes, João Ricardo Cordeiro; Sampaio, Roney Orismar; Tarasoutchi, Flávio. Frailty in Patients With Valve Disease: How to Assess?. International Journal of Cardiovascular Sciences, v. 36, e20210277, Mar. 2023.

Electronic Document Format (APA)

Titinger, D. P., Rosa, V. E. E., Ochiai, M. E., Accorsi, T. A., Fernandes, J. R. C., Sampaio, R. O., & Tarasoutchi, F. (2023). Frailty in Patients With Valve Disease: How to Assess?. International Journal of Cardiovascular Sciences, 36, e20210277.

Electronic Document Format (ISO)

Titinger, David Provenzale and Rosa, Vitor Emer Egypto and Ochiai, Marcelo Eidi and Accorsi, Tarso Augusto and Fernandes, João Ricardo Cordeiro and Sampaio, Roney Orismar and Tarasoutchi, Flávio. Frailty in Patients With Valve Disease: How to Assess?. International Journal of Cardiovascular Sciences [online]. 2023, vol. 36, [cited 2026-10-14], e20210277. Available from: <https://journals.cardiol.br/article/frailty-in-patients-with-valve-disease-how-to-assess/>. ISSN 2359-4802

EndNote RIS

Electronic Document Format (Vancouver)

Dan K, Shionoda A, Matsubara H. Systematic Staged Percutaneous Balloon Pulmonary Angioplasty in Severe Inoperable Chronic Thromboembolic Pulmonary Hypertension. Arquivos Brasileiros de Cardiologia 2021;116(2 suppl 1):21-4.

Electronic Document Format (ABNT)

Dan, Kazuhiro; Shionoda, Akira; Matsubara, Hiromi. Systematic Staged Percutaneous Balloon Pulmonary Angioplasty in Severe Inoperable Chronic Thromboembolic Pulmonary Hypertension. Arquivos Brasileiros de Cardiologia, v. 116, n. 2 suppl 1, p. 21-24, Feb. 2021.

Electronic Document Format (APA)

Dan, K., Shionoda, A., & Matsubara, H. (2021). Systematic Staged Percutaneous Balloon Pulmonary Angioplasty in Severe Inoperable Chronic Thromboembolic Pulmonary Hypertension. Arquivos Brasileiros de Cardiologia, 116(2 suppl 1), 21-24.

Electronic Document Format (ISO)

Dan, Kazuhiro and Shionoda, Akira and Matsubara, Hiromi. Systematic Staged Percutaneous Balloon Pulmonary Angioplasty in Severe Inoperable Chronic Thromboembolic Pulmonary Hypertension. Arquivos Brasileiros de Cardiologia [online]. 2021, vol. 116, n. 2 suppl 1, [cited 2026-10-14], pp. 21-24. Available from: <https://journals.cardiol.br/en/article/systematic-staged-percutaneous-balloon-pulmonary-angioplasty-in-severe-inoperable-chronic-thromboembolic-pulmonary-hypertension/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Rodrigues MK, Marques A, Lobo DML, Umeda IIK, Oliveira MF. Pre-Frailty Increases the Risk of Adverse Events in Older Patients Undergoing Cardiovascular Surgery. Arquivos Brasileiros de Cardiologia 2017;109(4):299-306.

Electronic Document Format (ABNT)

Rodrigues, Miguel K.; Marques, Artur; Lobo, Denise M. L.; Umeda, Iracema I. K.; Oliveira, Mayron F.. Pre-Frailty Increases the Risk of Adverse Events in Older Patients Undergoing Cardiovascular Surgery. Arquivos Brasileiros de Cardiologia, v. 109, n. 4, p. 299-306, Sep. 2017.

Electronic Document Format (APA)

Rodrigues, M. K., Marques, A., Lobo, D. M. L., Umeda, I. I. K., & Oliveira, M. F. (2017). Pre-Frailty Increases the Risk of Adverse Events in Older Patients Undergoing Cardiovascular Surgery. Arquivos Brasileiros de Cardiologia, 109(4), 299-306.

Electronic Document Format (ISO)

Rodrigues, Miguel K. and Marques, Artur and Lobo, Denise M. L. and Umeda, Iracema I. K. and Oliveira, Mayron F.. Pre-Frailty Increases the Risk of Adverse Events in Older Patients Undergoing Cardiovascular Surgery. Arquivos Brasileiros de Cardiologia [online]. 2017, vol. 109, n. 4, [cited 2026-10-14], pp. 299-306. Available from: <https://journals.cardiol.br/en/article/pre-frailty-increases-the-risk-of-adverse-events-in-older-patients-undergoing-cardiovascular-surgery/>. ISSN 0066-782X

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