Right ventricle dysfunction and echocardiographic parameters in the first 24h following resuscitation in the
Gabriel Wardi1, Daniel Blanchard2, Teri Dittrich2
1Department of Emergency Medicine, UC San Diego Health System, 200 West Arbor Drive, San Diego, CA 92103, United States; Division of Pulmonary and Critical Care Medicine, UC San Diego Health System, 200 West Arbor Drive, San Diego, CA 92103, United States.
Objectives:
To describe the echocardiographic parameters of the right ventricle (RV) in first 24h post-cardiac arrest (CA) in humans; to determine if the etiology of arrest predicts RV dysfunction; to quantify parameters of the right ventricle in the first 24h post-CA.
Design:
Retrospective cohort study. Arrests were categorized by as circulatory, respiratory, or arrhythmia. RV fractional area change (RVFAC), longitudinal strain (LS), tricuspid annular plane systolic excursion (TAPSE), and right ventricular dimensions were evaluated. We defined RV dysfunction as the presence of an abnormal RVFAC, TAPSE or LS based on the latest echocardiographic guidelines. Structural abnormalities were defined as the presence of abnormal longitudinal strain, RV mid-diameter, basal diameter and RV end diastole/systole.
Setting:
Two academic inpatient facilities between 2010 and 2013.
Patients:
All patients with successful resuscitation following CA with a technically adequate echocardiogram within 24h.
Measurements And Main Results:
Fifty-nine patients met inclusion criteria. Nineteen subjects had CA from a circulatory etiology, 23 from arrhythmias, and 17 from respiratory causes. Fifty-two of 59 patients met criteria for having functional anomalies of the RV. There was no statistical difference between the etiology of CA and the presence of RV dysfunction (p=0.106). Fifty-seven of 59 patients had evidence of structural abnormalities.
Conclusions:
RV dysfunction is present in the majority of post-CA patient regardless of the etiology of arrest. Further studies are needed to investigate if there are relationships between echocardiographic findings and survival and to assess temporal findings of RV function post-CA.
