{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T22:36:56Z","timestamp":1793572616259,"version":"4.5.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T00:00:00Z","timestamp":1664150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Canadian VIGOUR Centre"},{"DOI":"10.13039\/100016949","name":"Tenax Therapeutics","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100016949","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>High-risk cardiac surgery is commonly complicated by low cardiac output syndrome (LCOS), which is associated with high mortality. There are limited data derived from multi-centre studies with adjudicated endpoints describing factors associated with LCOS and its downstream clinical outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>The Levosimendan in Patients with Left Ventricular Systolic Dysfunction Undergoing Cardiac Surgery Requiring Cardiopulmonary Bypass (LEVO-CTS) trial evaluated prophylactic levosimendan vs. placebo in patients with a reduced ejection fraction undergoing coronary artery bypass grafting (CABG) and\/or valve surgery. We conducted a pre-specified analysis on LCOS, which was characterized by a four-part definition. We constructed a multivariable logistical regression model to evaluate risk factors associated with LCOS and performed Cox proportional hazards modelling to determine the association of LCOS with 90-day mortality. A total of 186 (22%) of 849 patients in the LEVO-CTS trial developed LCOS. The factors most associated with a higher adjusted risk of LCOS were pre-operative ejection fraction [odds ratio (OR) 1.26; 95% confidence interval (CI): 1.08\u20131.46 per 5% decrease] and age (OR 1.13; 95% CI: 1.04\u20131.24 per 5-year increase), whereas isolated CABG surgery (OR 0.44, 95% CI: 0.31\u20130.64) and levosimendan use (OR 0.65; 95% CI: 0.46\u20130.92) were associated with a lower risk of LCOS. Patients with LCOS had worse outcomes, including renal replacement therapy at 30-day (10 vs. 1%) and 90-day mortality (16 vs. 3%, adjusted hazard ratio of 5.04, 95% CI: 2.66\u20139.55).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Low cardiac output syndrome is associated with a high risk of post-operative mortality in high-risk cardiac surgery.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjacc\/zuac114","type":"journal-article","created":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T21:12:02Z","timestamp":1663708322000},"page":"818-825","source":"Crossref","is-referenced-by-count":12,"title":["Predictors and associated clinical outcomes of low cardiac output syndrome following cardiac surgery: insights from the LEVO-CTS trial"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3570-2136","authenticated-orcid":false,"given":"Ajar","family":"Kochar","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, Brigham and Women\u2019s Hospital , 75 Francis Street , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinggan","family":"Zheng","sequence":"additional","affiliation":[{"name":"Canadian VIGOUR Centre at the University of Alberta , 40129 Edmonton, AB T6G , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"van Diepen","sequence":"additional","affiliation":[{"name":"Canadian VIGOUR Centre at the University of Alberta , 40129 Edmonton, AB T6G , Canada"},{"name":"Department of Critical Care Medicine and Division of Cardiology, Department of Medicine, University of Alberta , Edmonton, Alberta , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajendra H","family":"Mehta","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University Medical Center , 300 W. 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