Echocardiographic Evidence of Cardiac Atrophy in the Critically Ill
Abirami Kumaresan1, Ameeka Pannu2, Ariel Mueller3
1Department of Anesthesiology and Cardiac Surgery, Smidt Heart Institute Cedar-Sinai Medical Center, Los Angeles, CA.
Abstract:
The purpose of this explorative study is to determine if critically ill patients experience cardiac atrophy that can be quantified as a loss of left ventricular mass (LVM) and thus detected by echocardiography.
Design:
Retrospective single-center cohort study.
Setting:
Patients admitted to a tertiary medical center in Boston, MA.
Patients:
Adult critically ill patients with ICU length of stay greater than or equal to 5 days.
Interventions:
None.
Measurements And Main Results:
We conducted a retrospective cohort study of 68 patients, of which 42 were included in the final analysis (mean age 60.9 ± 19.2 yr; 47.6% male). The median length of ICU stay was 11.3 days (interquartile range, 6.8-20.1 d). A decrease in mean LVM over the course of admission for critical illness was observed (median 189.11 g [162.82-240.20 g] vs 176.69 g [142.37-226.26 g]; p = 0.01). After adjusting for sex, age, fluid balance, ICU type, dietary orders, time between echocardiograms, and vasopressor use, this decrease in LVM remained consistent (mean difference, -21.30 g; 95% CI, -41.85 to -0.74; p = 0.04). Relative wall thickness (RWT) did not change during admission.
Conclusions:
These data reveal that a loss of LVM is present in patients over their ICU stay without a corresponding change in RWT, consistent with cardiac atrophy. Future prospective studies are needed to confirm these findings and identify possible sequelae of this finding.
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