Author + information
- Jacob Colin Jentzer,
- Sunil Mankad,
- Sorin Pislaru,
- Gregory Barsness,
- Kianoush Kashani,
- Alejandro Rabinstein and
- Roger White
Background: Systolic dysfunction is common on echocardiogram after cardiac arrest, but its prognostic value remains uncertain.
Methods: We retrospectively reviewed 173/190 patients treated with therapeutic hypothermia at Mayo Clinic St. Mary's Hospital after OHCA between December 2005 and March 2014 who underwent echocardiography during hospitalization; 129 had left ventricular outflow tract (LVOT) spectral Doppler peak velocity or velocity-time integral (VTI) recorded. We evaluated the association of left ventricular ejection fraction (LVEF), peak LVOT velocity and LVOT VTI as well as estimates of stroke volume and cardiac output (and these values indexed to body surface area) with inpatient mortality using receiver-operator curve analysis followed by multivariate analysis using JMP version 10. Means were compared using two-tailed t-test at p <0.05.
Results: Mean age was 62±12.3 years and 72.6% were male. The rhythm was shockable in 89%, and 35% had ST-elevation myocardial infarction (STEMI); 37% underwent percutaneous coronary intervention. Heart rate and blood pressure at the time of echocardiogram did not differ between hospital survivors and non-survivors. Mean LVEF did not differ significantly between hospital survivors and non-survivors (40±17% vs. 41±18%, p = 0.80). Peak LVOT velocity (89±25 vs. 90±21 cm/s), LVOT VTI (17±5 vs. 16±4 cm), stroke volume (71±24 vs. 66±17 ml), stroke volume index (32±8 ml/m2 vs. 34±10 ml/m2), cardiac output (5.0 +/- 2.3 vs. 4.8 +/- 1.6 L/min) and cardiac index (2.3±0.7 L/min/m2 vs. 2.4±1.1 L/min/m2) did not differ significantly between hospital survivors and non-survivors (all p >0.1). None of these measured parameters was a significant predictor of inpatient mortality (n = 53, 31%) or overall mortality during 3.1±3.0 years of follow-up (n = 74, 43%) on univariate or multivariate analysis (all p >0.05).
Conclusions: Left ventricular systolic function, defined by LVEF or LVOT spectral Doppler measurements, is not associated with increased inpatient mortality after cardiac arrest.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Innovative Use of Echocardiography
Abstract Category: 28. Non Invasive Imaging: Echo
Presentation Number: 1197-219
- 2017 American College of Cardiology Foundation