Background Perioperative cardioprotection is essential for achieving satisfactory clinical outcomes in heart failure patients. It is important to understand the factors affecting perioperative cardioprotection.

Methods The institutional database was searched for patients with reduced ejection fraction (EF, < 40%) who underwent surgery with cardioplegia-induced arrest. Patients were divided into del Nido cardioplegia (DN) and cold blood cardioplegia (CB) groups. The relationships between age, preoperative blood parameters, creatinine, cross-clamp time (CCT), extracorporeal circulation time (ECT), and postoperative troponin values at 12 hours or deterioration of EF (≥5%) were evaluated. Baseline characteristics, operative parameters, and outcomes were analyzed.

Results There were 508 patients with reduced EF (331 DN and 177 CB). In the entire cohort, anemic patients had greater troponin values (p = 0.004) as well as in the DN group (p = 0.002). However, this was not detected in the CB group (flat regression line; p = 0.674). Patients with high leukocyte values had greater troponin release (entire cohort: p < 0.001; DN group: p < 0.001; CB group: steep regression line with p = 0.042). Longer CCT and ECT were associated with greater troponin release (entire cohort; both groups) and greater risk of fall in EF. In a direct comparison, fewer patients had significant deterioration of EF in the DN group than CB group (3.9 vs. 11.9%; p < 0.001).

Conclusion The use of CB cardioplegia may be beneficial in anemic patients, whereas the use of DN cardioplegia may be beneficial for expected long CCT and high leukocytosis.

背景 围手术期心脏保护对于心力衰竭患者获得满意的临床结果至关重要。了解影响围手术期心脏保护的因素很重要。

方法 在机构数据库中搜索接受心脏停搏诱导骤停手术的射血分数降低（EF < 40%）的患者。患者被分为 del Nido 心脏停跳液 (DN) 组和冷血心脏停跳液 (CB) 组。评估年龄、术前血液参数、肌酐、交叉钳夹时间（CCT）、体外循环时间（ECT）和术后12小时肌钙蛋白值或EF恶化（≥5%）之间的关系。分析了基线特征、手术参数和结果。

结果 EF 降低的患者有 508 例（331 例 DN，177 例 CB）。在整个队列中，贫血患者的肌钙蛋白值较高 ( p  = 0.004)，DN 组的肌钙蛋白值也较高 ( p  = 0.002)。然而，在 CB 组中没有检测到这一点（平坦回归线；p  = 0.674）。白细胞值高的患者肌钙蛋白释放较多（整个队列：p  < 0.001；DN 组：p  < 0.001；CB 组：陡峭回归线，p  = 0.042）。较长的 CCT 和 ECT 与肌钙蛋白释放较多（整个队列；两组）以及 EF 下降的风险较高相关。在直接比较中，DN 组 EF 显着恶化的患者少于 CB 组（3.9% vs. 11.9%；p  < 0.001）。

结论 使用 CB 心脏停跳液可能对贫血患者有益，而使用 DN 心脏停跳液可能有利于预期的长 CCT 和高白细胞升高。