Improvement of Cardiac and Pulmonary Function in Patients With Moderate-to-Severe Idiopathic Scoliosis After Posterior Corrective surgery-A Single-Center, Prospective Cohort Study.

Abstract

Study DesignProspective single-center cohort study.ObjectiveTo evaluate cardiac morphology, cardiac function, and pulmonary hypertension impairment in patients with idiopathic scoliosis (IS) and their changes one year after scoliosis surgery.Methods70 patients with IS with predominantly thoracic curvature Cobb angle >40° were enrolled and categorized into moderate (<70°) and severe (≥70°) groups. Preoperative radiography and transthoracic echocardiography were performed. Postoperatively, 51 patients completed a one-year follow-up and were compared with preoperative data.Results(1) Left ventricular end-diastolic diameter (LVEDD), left ventricular global longitudinal strain (LVGLS), and e were lower and E/e was higher in the moderate vs severe group, and the aortic internal diameter and LVEF were lower in the severe group than in the control group (<i>P</i> < 0.05); (2) Right ventricular free wall strain (RVFWS), tricuspid annular plane systolic excursion (TAPSE), and TAPSE/systolic pulmonary artery pressure (SPAP) were lower, and SPAP was higher in the moderate vs severe group than in the control group (<i>P</i> < 0.05); (3) The thoracic curve Cobb angle was significantly negatively correlated with LVEDD, SV, LVGLS, RVFWS, TAPSE, TAPSE/SPAP and FVC and FEV1 measured/predicted (<i>P</i> < 0.05), and positively correlated with SPAP (<i>P</i> < 0.05); (4) After one-year postoperative follow-up, LVEDD, LVGLS, SV, e, RVFWS, TAPSE and TAPSE/SPAP were higher, and E/e and SPAP were lower (<i>P</i> < 0.05) compared to pre-operation.ConclusionCardiac morphology, left and right heart function, and pulmonary function were impaired in patients with IS, and which showed significant improvement after posterior corrective surgery.